Tri-City Medical Clinic PLC

Organization Active NPI Infectious Disease Physician · Coloma, MI

NPI 1497780654 · NPPES record last updated Feb 12, 2008

Key facts

NPI
1497780654
Entity type
Organization (NPI type 2)
Primary specialty
Infectious Disease Physician 207RI0200X
License
4301068832 (MI)
Legal business name
TRI-CITY MEDICAL CLINIC PLC
Practice address
6633 Red Arrow Hwy
Coloma, MI 49038-8717
Phone
(269) 468-7684
Fax
(269) 468-7687
NPI assigned
Jul 12, 2006
Organization subpart
No

Authorized official

Name
Aurora B Madanguit, MD
Title
Owner
Phone
(269) 468-7684

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RI0200X 4301068832 MI Yes

Addresses

Primary practice location

6633 Red Arrow Hwy
Coloma, MI 49038-8717

Mailing address

6633 Red Arrow Hwy
Coloma, MI 49038-8717
Phone (269) 468-7684

Other identifiers

IdentifierTypeStateIssuer
4341536MedicaidMI

Other providers in Coloma, MI

All providers in Coloma, MI · Infectious Disease Physician in Michigan

Sources for this page

Verify at the official NPI Registry.