Organization
BENTON HARBOR HEALTH CENTER PLLC
Active
Other names
Don J. Tynes M. D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DON J. TYNES M,D, (CHIEF MEDICAL OFFICER)
(269) 926-8535
Entity
Organization
Contact information
Practice address
687 E EMPIRE AVE, SUITE 101, BENTON HARBOR, MI 49022-4857
(269) 926-8535
(269) 926-8528
Mailing address
687 E EMPIRE AVE, SUITE 101, BENTON HARBOR, MI 49022-4857
(269) 926-8535
(269) 926-8528
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301065652
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10-4662247
—
MI
01
—
4301065652
STATE LICENSE
MI
Enumeration date
03/16/2007
Last updated
02/29/2012
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