Organization
STRATEGIC MEDICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH WHITESIDE MD (PRESIDENT)
(989) 894-3145
Entity
Organization
Contact information
Practice address
1900 COLUMBUS AVE, BAY CITY, MI 48708-6831
(989) 894-3145
(989) 894-6102
Mailing address
4100 EMBASSY DRIVE SE, SUITE 200, GRAND RAPIDS, MI 49546-2416
(616) 975-1845
(616) 285-0846
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
4301046418
MI
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700Z911040
BCBS MI
MI
Enumeration date
03/22/2007
Last updated
08/01/2011
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