Provider Demographics
NPI:1356744692
Name:WMU SCHOOL OF MEDICINE CMDS CLINIC
Entity type:Organization
Organization Name:WMU SCHOOL OF MEDICINE CMDS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DEAN FOR ADMIN & FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAUBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-337-4508
Mailing Address - Street 1:1000 OAKLAND DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-1282
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 OAKLAND DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008
Practice Address - Country:US
Practice Address - Phone:269-337-6019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESTERN MICHIGAN UNIVERSITY SCHOOL OF MEDICINE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-01
Last Update Date:2025-03-17
Deactivation Date:2021-06-24
Deactivation Code:
Reactivation Date:2025-03-17
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty