Organization
MICHIGAN ORTHOPEDIC SURGERY AND REHABILITATION, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATTI PIERMAN (CREDENTIALING SPECIALIST)
(269) 341-6417
Entity
Organization
Contact information
Practice address
6565 W MAIN ST, SUITE 235, KALAMAZOO, MI 49009-6114
(269) 544-4715
(269) 544-4719
Mailing address
6565 W MAIN ST, SUITE 235, KALAMAZOO, MI 49009-6114
(269) 544-4715
(269) 544-4719
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301041296
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003984572
BLUE CARE NETWORK
MI
05
—
2576506
—
MI
01
—
791203295
R/R MEDICARE PIN
—
Enumeration date
03/11/2008
Last updated
10/24/2017
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