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ADVANTAGE HEALTH CLINIC FOR MEN INC NPI 1316145972


NPI Information

NPI: 1316145972
Provider Name: ADVANTAGE HEALTH CLINIC, FOR MEN, INC
Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

Address:
18625 CENTENNIAL RD
SUITE D
MARSHALL, MI
ZIP 49068
Phone: (269) 789-1900
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ADVANTAGE HEALTH CLINIC, FOR MEN, INC is an adult medicine family medicine in Marshall, MI. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. ADVANTAGE HEALTH CLINIC, FOR MEN, INC NPI is 1316145972. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

18625 CENTENNIAL RD
SUITE D
MARSHALL, MI
ZIP 49068-372
Phone: (269) 789-1900
Fax: (269) 789-1974

The provider's authorized official is Lisa A Ignatoski .
The authorized official title is Manager and has the following contact phone number (269) 789-1900.

The enumeration date for this NPI number is 7/5/2007 and was last updated on 5/29/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QA0505XFamily MedicineAdult Medicine4301033625MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11952416877OTHERMICHIGANINDIVIDUAL NPI
20M49480MEDICARE UPINMICHIGAN
3F05571OTHERMICHIGANUPIN
41101312522OTHERMICHIGANWULFBCINDPIN
51043379530OTHERMICHIGANNPI INDIVIDUAL
61952416877OTHERMICHIGANNPI
74301055180OTHERMICHIGANSTE LICENSE NUMBER
84301055180OTHERMICHIGANLICENSE NUMBER
93522410MEDICAIDMICHIGAN
10CR033625OTHERMICHIGANMICHIGAN LICENSE NUMBER
111316145972OTHERMICHIGANGROUP NPI
12G05602OTHERMICHIGANUPIN
13700A310290OTHERMICHIGANBLUE CROSS BLUE SHIELD
140M49480005MEDICARE PINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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