Organization · NPI-2

20th Street Clinic PC

Family Medicine · Battle Creek, MI

NPI number1578744918
StatusActive
Last updated in NPPESMar 27, 2013

Details

NPI
1578744918
Entity type
Organization (NPI-2)
Legal business name
20th Street Clinic PC
Organization subpart
No
Enumeration date
Nov 14, 2007
Last updated
Mar 27, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine5101004673MIYes

Practice location

105 N 20th St
Battle Creek, MI 49015-1746

Phone 269-969-6010 · Fax 269-964-8422

Mailing address

105 N 20th St
Battle Creek, MI 49015-1746

Phone 269-969-6010 · Fax 269-964-8422

Authorized official

Stephen Fedele
Owner
2699696010

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