# HEALTHCARE MIDWEST PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HEALTHCARE MIDWEST, PC
- **Other names:** HealthCare Midwest Urology
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1215158191
- **Legal business name:** HEALTHCARE MIDWEST, PC
- **Authorized official:** MR. JAMES E MCKERNAN (ADMINISTRATOR)
- **Authorized official phone:** (269) 373-4646

## Contact information

- **Practice address:** 601 JOHN ST, SUITE M206C, KALAMAZOO, MI 49007-5341
- **Practice address phone:** (269) 349-9745
- **Practice address fax:** (269) 488-8305
- **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 |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

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

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 340C910480 | BLUE CROSS GRP PIN | MI |