# HEALTHCARE MIDWEST PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HEALTHCARE MIDWEST, PC
- **Other names:** LifeTime Wellness in Internal Medicine & Pediatrics A Division of Heal
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1093936999
- **Legal business name:** HEALTHCARE MIDWEST, PC
- **Authorized official:** MR. JAMES E MCKERNAN (ADMINISTRATOR)
- **Authorized official phone:** (269) 373-4646

## Contact information

- **Practice address:** 4613 W MAIN ST, SUITE A, KALAMAZOO, MI 49006-2645
- **Practice address phone:** (269) 488-8672
- **Practice address fax:** (269) 488-8673
- **Mailing address:** 4341 S WESTNEDGE AVE, SUITE 2205, KALAMAZOO, MI 49008-3289
- **Mailing address phone:** (269) 373-4646
- **Mailing address fax:** (269) 373-7655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 05/01/2007
- **Last updated:** 08/11/2010