Midwest Psychology, Pc | |
905 S Stewart Ave Fremont MI 49412-9201 | |
(231) 924-5309 | |
(231) 924-1685 |
Full Name | Midwest Psychology, Pc |
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Speciality | Psychologist |
Location | 905 S Stewart Ave, Fremont, Michigan |
Authorized Official Name and Position | Gailord Charles Weeks (PRESIDENT) |
Authorized Official Contact | 2319245309 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Midwest Psychology, Pc 905 S Stewart Ave Fremont MI 49412-9201 Ph: (231) 924-5309 | Midwest Psychology, Pc 905 S Stewart Ave Fremont MI 49412-9201 Ph: (231) 924-5309 |
NPI Number | 1154464907 |
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Provider Enumeration Date | 02/14/2007 |
Last Update Date | 09/21/2009 |
Medicare PECOS PAC ID | 8921172917 |
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Medicare Enrollment ID | O20080808000794 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154464907 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | 6301003219 (Michigan) | Primary |
Provider Name | Gailord C Weeks |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1841252590 PECOS PAC ID: 0749386506 Enrollment ID: I20070511000043 |
Provider Name | Paul S Hewitt |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1851549745 PECOS PAC ID: 4183816135 Enrollment ID: I20101008000125 |
Provider Name | Daniel R Henderson |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1518927573 PECOS PAC ID: 0648467837 Enrollment ID: I20101214000960 |
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