Provider Demographics
NPI:1619981891
Name:NEW DAY FAMILY MEDICINE & MEDICAL SPA, P.C.
Entity Type:Organization
Organization Name:NEW DAY FAMILY MEDICINE & MEDICAL SPA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PLOEHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-979-5100
Mailing Address - Street 1:3600 CAPITAL AVE SW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-9393
Mailing Address - Country:US
Mailing Address - Phone:269-979-5100
Mailing Address - Fax:269-979-5480
Practice Address - Street 1:3600 CAPITAL AVE SW
Practice Address - Street 2:SUITE 201
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-9393
Practice Address - Country:US
Practice Address - Phone:269-979-5100
Practice Address - Fax:269-979-5480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059704261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF92023Medicare UPIN