Northridge Family Practice Llc in Hale - Internal Medicine
Northridge Family Practice Llc - NPI 1891712493
Northridge Family Practice Llc is a Internal Medicine in Hale, Michigan. Northridge Family Practice Llc practices all healthcare services and medical treatments related to Internal Medicine. The NPI Number for Northridge Family Practice Llc is 1891712493. The last update date is 2015-11-02.
Northridge Family Practice Llc's current location address is Po Box 279, Hale, Michigan. You can contact this provider via phone number 9897286000 and fax number 9897286003. The mailing address for Northridge Family Practice Llc is Po Box 279, Hale, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Northridge Family Practice Llc |
|---|---|
| Address | Po Box 279, Hale, Michigan |
| Phone Number | 9897286000 |
| Fax Number | 9897286003 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MANAGING O |
|---|---|
| Authorized Official Name | Provoast Kaye Debra |
| Credentials | RN MSN F |
| Telephone Number | 9897286000 |
NPI Number Detail
| NPI Number | 1891712493 |
|---|---|
| Provider Enumeration Date | 2006-07-17 |
| Last Updated Date | 2015-11-02 |
Provider Mailing Address Detail
| Address | Po Box 279 |
|---|---|
| City | Hale |
| State | Michigan (MI) |
| Post Code | 487390279 |
| Phone Number | 9897286000 |
| Fax Number | 9897286003 |
Provider's Primary Taxonomy Detail
| Speciality | Internal Medicine |
|---|---|
| Taxonomy | 207R00000X |
| Licence No | 4301061417 |
|
Definition: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and di |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1017859 | MI | MCLAREN | |
| 105230710 | MI | -- | |
| BW148660 | MI | BETH WEAVER LICENSE | |
| MA061417 | MOHAMED ALI | ||
| RAILROAD MEDICA | MI | P00261196 | |
| 4704283185 | MI | LINDSEY LICENSE | |
| 104289418 | MI | -- | |
| 105235126 | MI | -- | |
| OC51020 | BLUE CROSS BLUE SHIELD | ||
| 1017858 | MI | MCLAREN DEB PROVOAST |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Northridge Family Practice Llc by the Centers for Medicare & Medicaid Services?
The Northridge Family Practice Llc has been issued the NPI (National Provider Identifier) 1891712493, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Northridge Family Practice Llc located?
The Northridge Family Practice Llc is located at Po Box 279, Hale, MI 487390279.
What is Northridge Family Practice Llc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Northridge Family Practice Llc's specialized field of practice is Internal Medicine, and the corresponding taxonomy code that categorizes this area of specialization is 207R00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1891712493 to Northridge Family Practice Llc?
The Centers for Medicare & Medicaid Services originally issued the 1891712493 to Northridge Family Practice Llc on 2006-07-17.
As of what date were the Northridge Family Practice Llc's details last updated?
The information pertaining to the Northridge Family Practice Llc, including its address, specialty, and other details, was most recently updated on 2015-11-02.