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Organization

EAST SIDE FAMILY PHYSICIANS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KENDRA KAY RICHARD MA (OFFICE MANAGER)
(989) 894-4700
Entity
Organization

Contact information

Practice address
618 MULHOLLAND ST, BAY CITY, MI 48708-7645
(989) 894-4700
(989) 895-6245
Mailing address
618 MULHOLLAND ST, BAY CITY, MI 48708-7645
(989) 894-4700
(989) 895-6245

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NC014980
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080Z910620
BLUE CROSS
MI
Enumeration date
08/30/2006
Last updated
07/17/2013
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