Organization
COMMUNITY CARE OF DOWAGIAC, PLLC
Active
Other names
Community Care of Dowagiac
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN BASHA PA-C (PROVIDER)
(269) 462-9587
Entity
Organization
Contact information
Practice address
57392 M 51 S, DOWAGIAC, MI 49047-9766
(269) 462-9587
(269) 462-9589
Mailing address
PO BOX 364, DOWAGIAC, MI 49047-0364
(269) 462-9587
(269) 462-9589
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4837343
—
MI
05
—
74575
—
MI
Enumeration date
08/10/2021
Last updated
09/25/2023
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