Organization
BORGESS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD MILLERMAIER (CMO)
(269) 552-2910
Entity
Organization
Contact information
Practice address
1521 GULL ROAD, KALAMAZOO, MI 49048
(269) 226-7000
Mailing address
5943 STADIUM DRIVE, KALAMAZOO, MI 49009
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P10C91094
BCBSM TRADITIONAL
—
Enumeration date
12/03/2007
Last updated
12/03/2007
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