Organization
HEALTHCARE MIDWEST PC
Active
Parent organization
HEALTHCARE MIDWEST, PC
Other names
HealthCare Midwest Hand & Elbow Surgery
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 M230, KALAMAZOO, MI 49007-5341
(269) 349-8601
(269) 349-6446
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
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200C910540
BLUE CROSS GRP PIN
MI
Enumeration date
05/01/2007
Last updated
08/11/2010
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