MEDICARE: UNIVERSITY MEDICAL SPECIALTIES, PC

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	207Q00000X	Family Medicine Physician	LH052398	MI
2	207R00000X	Internal Medicine Physician	KK081055	MI
3	208000000X	Pediatrics Physician	KK081055	MI
4	103T00000X	Psychologist	LH009414	MI
5	103T00000X	Psychologist	FK271098	MI
6	103T00000X	Psychologist	NC007536	MI
7	207Q00000X	Family Medicine Physician	DR064962	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	680A112130	OTHER	MI	GROUP MENTAL HEALTH BCBSM PIN
2	700A146860	OTHER	MI	MEDICAL GROUP BCBSM PIN

General Provider Information

NPI Number	:	1902086689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY MEDICAL SPECIALTIES, PC

Provider Business Mailing Address
First Line	:	9045 US HIGHWAY 31
Second Line	:
City	:	BERRIEN SPRINGS
State	:	MI
Zip	:	49103-1804
Country	:	US
Telephone Number	:	269-473-2222
Fax Number	:	269-473-6880

Provider Business Practice Location Address
First Line	:	9045 US HIGHWAY 31
Second Line	:
City	:	BERRIEN SPRINGS
State	:	MI
Zip	:	49103-1804
Country	:	US
Telephone Number	:	269-473-2222
Fax Number	:	269-473-6880

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	RAEANN DANENE LONG
Credential	:
Telephone Number	:	269-473-2222

Provider Enumeration Date	:	11/09/2007
Last Update Date	:	10/16/2008

Similar Medicare Providers

1104806116 — KATHERINE ANN KEITH M.D.
Practice Location Address:

9045 US HIGHWAY 31
BERRIEN SPRINGS, MI
49103-1804

Practice Phone: 269-473-2222
Practice Fax: 269-473-6880

1326018342 — DR. MICHAEL RODNEY QUION M.D.
Practice Location Address:

9045 US HIGHWAY 31 STE A
BERRIEN SPRINGS, MI
49103-1804

Practice Phone: 269-473-2222
Practice Fax: 269-473-6880

1043316557 — DR. ANDREA R BECKFORD DDS
Practice Location Address:

9045 US HIGHWAY 31
BERRIEN SPRINGS, MI
49103-1804

Practice Phone: 989-533-1888
Practice Fax: 269-471-9232

1598833279 — MRS. CHERIE MICHELLE WILSON FNP
Practice Location Address:

9045 US HIGHWAY 31
BERRIEN SPRINGS, MI
49103-1804

Practice Phone: 269-473-2222
Practice Fax: 269-473-6880

1487947446 — LAKELAND MEDICAL PRACTICES
Practice Location Address:

9045 US HIGHWAY 31 , STE 3
BERRIEN SPRINGS, MI
49103-1804

Practice Phone: 269-471-9702
Practice Fax: 269-471-9707

1194075002 — MS. KATRINA CELESTE HAMEL PA-C
Practice Location Address:

9045 US HIGHWAY 31 , SUITE A
BERRIEN SPRINGS, MI
49103-1804

Practice Phone: 269-473-2222
Practice Fax: 269-473-6880

Directions to “UNIVERSITY MEDICAL SPECIALTIES, PC ” 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 © 2007-2026 (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.