Provider Demographics
NPI:1336333723
Name:GENERAL AND VASCULAR SURGERY, P.C.
Entity Type:Organization
Organization Name:GENERAL AND VASCULAR SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:BABEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-343-9113
Mailing Address - Street 1:1717 SHAFFER STREET
Mailing Address - Street 2:SUITE 108
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1629
Mailing Address - Country:US
Mailing Address - Phone:269-343-9113
Mailing Address - Fax:269-343-0510
Practice Address - Street 1:1717 SHAFFER STREET
Practice Address - Street 2:SUITE 108
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1629
Practice Address - Country:US
Practice Address - Phone:269-343-9113
Practice Address - Fax:269-343-0510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB47155Medicare UPIN
MIC46087Medicare UPIN
MIG50271Medicare UPIN
MIF27391Medicare UPIN
MIE64400Medicare UPIN