Provider Demographics
NPI:1205327285
Name:MID MICHIGAN FAMILY MEDICINE AND HEALTH CARE SERVICES PLLC
Entity type:Organization
Organization Name:MID MICHIGAN FAMILY MEDICINE AND HEALTH CARE SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:ZARRILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-932-8638
Mailing Address - Street 1:612 GREEN AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-6847
Mailing Address - Country:US
Mailing Address - Phone:973-932-8638
Mailing Address - Fax:
Practice Address - Street 1:612 GREEN AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-6847
Practice Address - Country:US
Practice Address - Phone:973-932-8638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301108942207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty