Organization
ASCENSION MEDICAL GROUP PROMED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIN HOUGHTON (CFO)
(269) 226-4800
Entity
Organization
Contact information
Practice address
1555 E CHICAGO RD, STURGIS, MI 49091-1993
(269) 651-7114
Mailing address
1717 SHAFFER ST STE 2, KALAMAZOO, MI 49048-1623
(269) 552-2836
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350C910110
BCBSM
—
Enumeration date
08/07/2006
Last updated
12/30/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up