| NPI | 1740417153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY CHERYL ERINS Credentialing Specialist 269-244-5256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 213E00000X Podiatrist |
| 367A00000X Advanced Practice Midwife | |
| 208600000X Surgery | |
| 208M00000X Hospitalist | |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 207Y00000X Otolaryngology | |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2021-06-10 |