MEDICARE: WILLIAM J BEHRJE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	4301033411	MI

General Provider Information

NPI Number	:	1477662658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM J BEHRJE M.D.

Provider Business Mailing Address
First Line	:	1535 GULL RD
Second Line	:	STE 005
City	:	KALAMAZOO
State	:	MI
Zip	:	49048-1650
Country	:	US
Telephone Number	:	269-226-6917
Fax Number	:	269-226-7878

Provider Business Practice Location Address
First Line	:	5943 STADIUM DR
Second Line	:	STE 1
City	:	KALAMAZOO
State	:	MI
Zip	:	49009-3016
Country	:	US
Telephone Number	:	269-552-2898
Fax Number	:	269-552-2964

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	11/23/2009

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