# PROMEDICA NORTH PHYSICIANS CORPORATION

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

## Provider details

- **NPI number:** 1780228163
- **Authorized official:** KRISTIN KNUEVEN (CREDENTIALING SUPERVISOR)
- **Authorized official phone:** (567) 585-1969

## Contact information

- **Practice address:** 413 N CHICAGO ST, LITCHFIELD, MI 49252-9792
- **Practice address phone:** (517) 542-3217
- **Practice address fax:** (517) 542-3490
- **Mailing address:** PO BOX 639772, CINCINNATI, OH 45263-9775

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 207Y00000X | Otolaryngology Physician | — | NULL | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |

## Other

- **Enumeration date:** 10/29/2019
- **Last updated:** 10/29/2019