Organization Name: | PROMED HEALTHCARE |
NPI Number: | 1013926997 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EDWARD M MILLERMAIER (CMO) |
Mailing Address: | 8001 Angling Rd Portage |
State: | MI US |
Postal Code: | 490247422 |
Phone Number: | 2693290944 |
Fax Number: | |
NPI Enumeration Date: | 08/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |