Northridge Family Practice LLC
Northridge Family Practice LLC is an Internal Medicine Physician in Hale, Michigan. Licensed in Michigan. Registered with an NPI since 2007.
- Licensed in
- MI
- In the registry since
- 2007
- Specialties on file
- 2
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
3190 Northridge DrHale, MI 48739-9276
Phone: (989) 728-6000
Fax: (989) 728-6003
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinical Cardiac Electrophysiology Physician (primary) | Taxonomy 207RC0001X · Licence 5101011670 (MI) |
|---|---|
| Internal Medicine Physician | Taxonomy 207R00000X · Licence 4301061417 (MI) |
Record details
| NPI number | 1780803932 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Debra Provoast — Owner · (989) 728-6000 |
| NPI enumerated | April 25, 2007 |
| Last updated in NPPES | January 13, 2009 |
| Mailing address | Po Box 279, Hale, MI 48739-0279 |
Other providers in Hale
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Northridge Family Practice LLC
3190 Northridge Dr, Hale, MI 48739-9276 · (989) 728-6000