Organization
HEALTHCARE MIDWEST PC
Active
Parent organization
HEALTHCARE MIDWEST, PC
Other names
HealthCare Midwest Urology
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEALTHCARE MIDWEST, PC
Authorized official
MR. JAMES E MCKERNAN (ADMINISTRATOR)
(269) 373-4646
Entity
Organization
Contact information
Practice address
601 JOHN ST, SUITE M206C, KALAMAZOO, MI 49007-5341
(269) 349-9745
(269) 488-8305
Mailing address
4341 S WESTNEDGE AVE, SUITE 2205, KALAMAZOO, MI 49008-3289
(269) 373-4646
(269) 373-7655
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
340C910480
BLUE CROSS GRP PIN
MI
Enumeration date
05/01/2007
Last updated
08/11/2010
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