Organization
WEST MICHIGAN CANCER CENTER
Active
Parent organization
WEST MICHIGAN CANCER CENTER
Other names
West Michigan Cancer Center Radiation Oncology
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) 341-7806
(269) 341-8743
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2430038
UHC
—
01
—
320C91143
BCBSM
—
01
—
320C960590
BCBSM
—
Enumeration date
08/18/2006
Last updated
11/30/2011
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