Organization
GOODHOPE MEDICAL GROUP
Active
Parent organization
LAKE REGION MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKE REGION MEDICAL CENTER
Authorized official
DR. CHARLES MOSIMBWA MD (MEDICAL DIRECTOR)
(269) 471-9436
Entity
Organization
Contact information
Practice address
8981 GEORGE AVE, BERRIEN SPRINGS, MI 49103-1407
(269) 471-9436
Mailing address
8981 GEORGE AVE, BERRIEN SPRINGS, MI 49103-1407
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
03/01/2011
Last updated
03/01/2011
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