Unknown Individual – Family Medicine Physician, NPI 1376535740
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Lakeland Hospital, Watervliet, 400, Medical Park Drive, Watervliet, Berrien County, Michigan, 49098, United States
WATERVLIET, MI 490989225
Phone: (269) 621-6416
Type: Mailing
525, South Center Street, Hartford, Van Buren County, Michigan, 49057, United States
HARTFORD, MI 490571362
Phone: (269) 621-4063
Fax: (269) 621-9972
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 49098)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Clinical Psychologist | PA | |
| Family Practice | MI | |
| Internal Medicine | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Physician Assistant | MI | |
| Family Practice | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI |
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