MEDICARE: KALMAZOO GASTROENTEROLOGY HEPATOLOGY AND DIGESTIVE HEALTH CENTER

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	363AM0700X	Medical Physician Assistant	5601006118	MI

General Provider Information

NPI Number	:	1831470285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KALMAZOO GASTROENTEROLOGY HEPATOLOGY AND DIGESTIVE HEALTH CENTER

Provider Business Mailing Address
First Line	:	1535 GULL RD STE 105
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49048-1630
Country	:	US
Telephone Number	:	269-385-9900
Fax Number	:	269-385-2140

Provider Business Practice Location Address
First Line	:	1535 GULL RD STE 105
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49048-1630
Country	:	US
Telephone Number	:	269-385-9900
Fax Number	:	269-385-2140

Authorized Official
Title or Position	:	PHYSICIAN ASSISTANT
Name	:	MR. LANCE LINCOLN PRIDE
Credential	:	PAC
Telephone Number	:	269-385-9900

Provider Enumeration Date	:	08/30/2011
Last Update Date	:	08/30/2011

Similar Medicare Providers

1649273855 — DR. UMAKANT SHIVLAL DOCTOR M.D.
Practice Location Address:

1535 GULL RD , STE 110
KALAMAZOO, MI
49048-1630

Practice Phone: 269-276-0800
Practice Fax: 269-276-0801

1255526810 — MAURA K SULLIVAN PA
Practice Location Address:

1535 GULL ROAD , SUITE 105
KALAMAZOO, MI
49048-1630

Practice Phone: 269-385-9900
Practice Fax: 269-385-2140

1770373631 — PATRICK KURTZ
Practice Location Address:

2019 RAMBLING RD
KALAMAZOO, MI
49008-1630

Practice Phone: 269-345-0909
Practice Fax:

1831169861 — DR. ROBERT RAYMOND GERL D. MIN., PH.D.
Practice Location Address:

2019 RAMBLING RD
KALAMAZOO, MI
49008-1630

Practice Phone: 269-345-0909
Practice Fax: 269-345-4985

1740295492 — DESERT STREAMS P C
Practice Location Address:

2019 RAMBLING RD
KALAMAZOO, MI
49008-1630

Practice Phone: 269-345-0909
Practice Fax: 269-345-4985

1750390951 — MR. CHRIS A AUGUSTINE MA LPC SCL
Practice Location Address:

2019 RAMBLING RD
KALAMAZOO, MI
49008-1630

Practice Phone: 269-345-0909
Practice Fax:

Directions to “KALMAZOO GASTROENTEROLOGY HEPATOLOGY AND DIGESTIVE HEALTH CENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.