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EDGEWATER FAMILY HEALTH PLC NPI 1710436571


NPI Information

NPI: 1710436571
Provider Name: EDGEWATER FAMILY HEALTH, PLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 23D1004849

Address:
405 MOMANY DRIVE
SAINT JOSEPH, MI
ZIP 49085
Phone: (269) 982-1947
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EDGEWATER FAMILY HEALTH, PLC is a family medicine in Saint Joseph, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EDGEWATER FAMILY HEALTH, PLC NPI is 1710436571. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

405 MOMANY DRIVE
SAINT JOSEPH, MI
ZIP 49085-178
Phone: (269) 982-1947
Fax: (269) 982-1950

The provider's authorized official is Matthew J Campbell .
The authorized official title is Owner and has the following contact phone number (269) 982-1947.

The CLIA number assigned to this NPI record is 23D1004849 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/22/2016 and was last updated on 9/22/2016.


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
1207Q00000XFamily Medicine4301080141MICHIGANYes

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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