# JAMES SIRAJUDDIN MD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Riverside Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609065358
- **Authorized official:** DR. JAMES SIRAJUDDIN M.D. (PRESIDENT)
- **Authorized official phone:** (269) 637-2102

## Contact information

- **Practice address:** 203 CENTER ST, SOUTH HAVEN, MI 49090-1311
- **Practice address phone:** (269) 637-2102
- **Practice address fax:** (269) 637-3783
- **Mailing address:** 203 CENTER ST, SOUTH HAVEN, MI 49090-1311
- **Mailing address phone:** (269) 637-2102
- **Mailing address fax:** (269) 637-3783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 4301039518 | MI | Yes |

## Other

- **Enumeration date:** 10/18/2007
- **Last updated:** 04/01/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2111690 | — | MI |