Organization
MICHIGAN ORTHOPEDIC SURGERY AND REHABILITATION, P.C.
Active
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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