Organization
LAKE REGION MEDICAL CENTER, P.C.
Active
Other names
GOODHOPE MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES ANDREW MOSIMBWA M.D. (MEDICAL DIRECTOR)
(269) 362-7791
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
(269) 471-9436
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
208000000X
Pediatrics Physician
—
—
2085B0100X
Body Imaging Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
07/05/2007
Last updated
04/01/2011
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