Organization Name: | EUCLID MEDIAL GROUP PC |
NPI Number: | 1992962260 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM E BERNER (CLINIC ADMINISTRATOR) |
Mailing Address: | 4175 N Euclid Ave Bay City |
State: | MI US |
Postal Code: | 487062483 |
Phone Number: | 9896670491 |
Fax Number: | 9896670493 |
NPI Enumeration Date: | 05/22/2008 |
NPI Last Update Date: | 05/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |