Organization
BRANCH PEDIATRIC&ADOLESCENT MEDICINEPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEHALAI ARIVOLI MD (PRESIDENT)
(517) 924-1465
Entity
Organization
Contact information
Practice address
390 E CHICAGO ST, COLDWATER, MI 49036-2062
(616) 818-9750
Mailing address
390 E CHICAGO ST, COLDWATER, MI 49036-2062
(616) 818-9750
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
065709
MI
Other
Enumeration date
07/23/2015
Last updated
09/17/2021
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