| Ascension Medical Group Promed | |
|
8001 Angling Rd Portage MI 49024-7422 | |
| (269) 321-7090 | |
| Not Available |
| Full Name | Ascension Medical Group Promed |
|---|---|
| Speciality | Counselor |
| Location | 8001 Angling Rd, Portage, Michigan |
| Authorized Official Name and Position | Marina Houghton (CFO) |
| Authorized Official Contact | 2692264800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension Medical Group Promed 1717 Shaffer St Ste 2 Kalamazoo MI 49048-1623 Ph: (269) 552-2836 | Ascension Medical Group Promed 8001 Angling Rd Portage MI 49024-7422 Ph: (269) 321-7090 |
| NPI Number | 1063542165 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 12/30/2022 |
| Certification Date | 12/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063542165 | NPI | - | NPPES |
| 750910577 | Other | MI | BCBSM GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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