Provider Demographics
NPI:1245270685
Name:MIDLAND INTERNAL MEDICINE ASSOCIATES P.C.
Entity type:Organization
Organization Name:MIDLAND INTERNAL MEDICINE ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:NADOLSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-832-6400
Mailing Address - Street 1:5912 EASTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6839
Mailing Address - Country:US
Mailing Address - Phone:989-832-6400
Mailing Address - Fax:989-832-3663
Practice Address - Street 1:5912 EASTMAN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6839
Practice Address - Country:US
Practice Address - Phone:989-832-6400
Practice Address - Fax:989-832-3663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
602960800OtherUS DOL
110042864OtherPALMETTO GBA
MI1155613410OtherBLUE CROSS ROBERT WINTERMYER
MI1105610371OtherBLUE CROSS
MI1105610371OtherBLUE CARE NETWORK
MI0P07460OtherROBERT WINTERMYER
MI101483761Medicaid
0988691OtherHEALTH PLUS
MI5008704100OtherBLUE CROSS SARA CRAWFORD
MI0P07470Medicare PIN
MI0P07460OtherROBERT WINTERMYER
Q67369Medicare UPIN
R66397Medicare UPIN
B47054Medicare UPIN
MI1105610371OtherBLUE CROSS
110042864OtherPALMETTO GBA