Organization
FIDAMAR MEDICAL LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAIDHERBE CEUS (OWNER)
(845) 623-3120
Entity
Organization
Contact information
Practice address
451 W MILHAM AVE, PORTAGE, MI 49024-2721
(269) 254-8400
(269) 254-8350
Mailing address
451 W MILHAM AVE, PORTAGE, MI 49024-2721
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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