Provider Demographics
NPI:1033087390
Name:PERSONAL MEDICAL CARE PLLC
Entity type:Organization
Organization Name:PERSONAL MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:VELDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:999-999-9999
Mailing Address - Street 1:5036 STONEHENGE DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5727
Mailing Address - Country:US
Mailing Address - Phone:269-716-3574
Mailing Address - Fax:
Practice Address - Street 1:5036 STONEHENGE DR
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-5727
Practice Address - Country:US
Practice Address - Phone:269-716-3574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty