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Organization

WEST MICHIGAN CANCER CENTER

Active
Parent organization
WEST MICHIGAN CANCER CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
WEST MICHIGAN CANCER CENTER
Authorized official
DR. JOSEPH MIRRO (PRESIDENT/CEO/CMO)
(269) 382-2500
Entity
Organization

Contact information

Practice address
200 N PARK ST, KALAMAZOO, MI 49007-3731
(269) 382-2500
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-8419
(269) 341-8743

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
207VX0201X
Gynecologic Oncology Physician
2085R0001X
Radiation Oncology Physician
MI
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0C91143
BCBSM
MI
01
2430038
UHC
MI
Enumeration date
08/11/2006
Last updated
07/07/2014
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