Provider Demographics
NPI:1689756983
Name:CHARLOTTE FAMILY HEALTH, PC
Entity Type:Organization
Organization Name:CHARLOTTE FAMILY HEALTH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KWAPISZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-541-1000
Mailing Address - Street 1:134 S COCHRAN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-1557
Mailing Address - Country:US
Mailing Address - Phone:517-541-1000
Mailing Address - Fax:517-541-1753
Practice Address - Street 1:134 S COCHRAN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1557
Practice Address - Country:US
Practice Address - Phone:517-541-1000
Practice Address - Fax:517-541-1753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherTAX ID
MIF56613Medicare UPIN