East Side Family Physicians PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

NC014980 Issued in MI

Legal business name

EAST SIDE FAMILY PHYSICIANS PC

Practice address

618 Mulholland St
Bay City, MI 48708-7645

Phone

(989) 894-4700

Fax

(989) 895-6245

NPI assigned

Aug 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kendra Kay Richard, MA

Title

Office Manager

Phone

(989) 894-4700

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1124137344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 MULHOLLAND ST",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487087645",
            "telephone_number": "989-894-4700",
            "fax_number": "989-895-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 MULHOLLAND ST",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487087645",
            "telephone_number": "989-894-4700",
            "fax_number": "989-895-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE FAMILY PHYSICIANS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "RICHARD",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "989-894-4700",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "NC014980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "080Z910620",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Dwan
• Daniel Joseph Dymek, M.D.
• Jennifer Dziurka
• Kristy Dzurka
• Tiffany Rose Eager
• Fatima Ebrahim
• Ashle Ecker
• Erica Lynn Eckert
• Tim E Eckstein, DO
• Claire Elizabeth Economou

• Family Medicine Physician in Bay City, MI
• Providers in Bay City, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.