# GLADWIN FAMILY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356524789
- **Authorized official:** HICHAM CHURBAJI MD (OWNER)
- **Authorized official phone:** (989) 426-9399

## Contact information

- **Practice address:** 2137 W M 61, GLADWIN, MI 48624-8463
- **Practice address phone:** (989) 426-9399
- **Mailing address:** 3061 CHRISTY WAY, SAGINAW, MI 48603-2267
- **Mailing address phone:** (989) 426-9399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 164W00000X | Licensed Practical Nurse | SW130169 | MI | Yes |

## Other

- **Enumeration date:** 12/07/2007
- **Last updated:** 12/07/2007