Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
EASTGATE INTERNAL MEDICINE LTD
Active
Organization
EASTGATE INTERNAL MEDICINE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEGAN JABEZ M.D. (OWNER)
(269) 925-8842
Entity
Organization
Contact information
Practice address
1686 COLFAX AVE, BENTON HARBOR, MI 49022-7355
(269) 925-8842
(269) 925-8847
Mailing address
8734 VALLEY VIEW DR, BERRIEN SPRINGS, MI 49103-1617
(269) 925-8842
(269) 925-8847
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
4301064652
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073694006
NPI NUMBER-TYPE I
—
01
—
1101111252
BLUECROSS BLUESHIELD OF MICHIGAN
MI
05
—
415194310
—
MI
01
—
4301064652
MICHIGAN MEDICAL LICENSE NUMBER
MI
Enumeration date
09/18/2008
Last updated
09/18/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers