Individual
MRS. LOIDA S MEDINA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1850 PIPESTONE RD, SUITE 101, BENTON HARBOR, MI 49022-2304
(269) 925-6600
(269) 925-9528
Mailing address
1850 PIPESTONE RD, SUITE 101, BENTON HARBOR, MI 49022-2304
(269) 925-6600
(269) 925-9528
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301037695
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101100342
BCBS PIN NUMBER
MI
Enumeration date
06/09/2006
Last updated
07/09/2007
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