Provider Demographics
NPI:1124396643
Name:SOUTHERN MICHIGAN ORTHOPAEDICS PC
Entity Type:Organization
Organization Name:SOUTHERN MICHIGAN ORTHOPAEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESPONSIBLE PARTY
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:COMAI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:269-969-6251
Mailing Address - Street 1:710 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3258
Mailing Address - Country:US
Mailing Address - Phone:269-969-6251
Mailing Address - Fax:269-969-6283
Practice Address - Street 1:710 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3258
Practice Address - Country:US
Practice Address - Phone:269-969-6251
Practice Address - Fax:269-969-6283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-12
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty