Individual
DR. CECILIA MARIE PROPHIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 JOHN ST, SUITE M273, KALAMAZOO, MI 49007-5341
(269) 381-0180
(269) 381-7347
Mailing address
601 JOHN ST, SUITE M273, KALAMAZOO, MI 49007-5341
(269) 381-0180
(269) 381-7347
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301059008
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040C910710
BCBS GRP PIN
MI
01
—
155429
GREAT LAKES HLTH PLN
—
05
—
3011204-10
—
MI
01
—
3403902650
BCBS IND PIN
MI
01
—
5020219
AETNA PIN
—
Enumeration date
06/06/2006
Last updated
11/27/2023
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