Provider Demographics
NPI:1447411848
Name:MIDWEST VISITING PHYSICIANS, PC
Entity Type:Organization
Organization Name:MIDWEST VISITING PHYSICIANS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAMBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-465-6221
Mailing Address - Street 1:4299 LAKE ST # 85
Mailing Address - Street 2:
Mailing Address - City:BRIDGMAN
Mailing Address - State:MI
Mailing Address - Zip Code:49106-9109
Mailing Address - Country:US
Mailing Address - Phone:269-465-6221
Mailing Address - Fax:269-465-6299
Practice Address - Street 1:4299 LAKE ST # 85
Practice Address - Street 2:
Practice Address - City:BRIDGMAN
Practice Address - State:MI
Practice Address - Zip Code:49106-9109
Practice Address - Country:US
Practice Address - Phone:269-465-6221
Practice Address - Fax:269-465-6299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty