MEDICARE: VIOLA SAYLOR PAC

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	363A00000X	Physician Assistant	5601004187	MI
2	363AM0700X	Medical Physician Assistant	5601004187	MI
3	363AS0400X	Surgical Physician Assistant	5601004187	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0C97618	OTHER	MI	BCBSM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801894571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIOLA SAYLOR PAC

Provider Business Mailing Address
First Line	:	601 JOHN STREET
Second Line	:	SUITE M124
City	:	KALAMAZOO
State	:	MI
Zip	:	49007-5341
Country	:	US
Telephone Number	:	269-341-7500
Fax Number	:	269-341-7540

Provider Business Practice Location Address
First Line	:	601 JOHN STREET
Second Line	:	SUITE M124
City	:	KALAMAZOO
State	:	MI
Zip	:	49007-5341
Country	:	US
Telephone Number	:	269-341-7500
Fax Number	:	269-341-7540

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	10/15/2014

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Directions to “ VIOLA SAYLOR PAC” Practice Location

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