| 20th Street Clinic Pc | |
|
105 N 20th St Battle Creek MI 49015-1746 | |
| (269) 969-6010 | |
| (269) 964-8422 |
| Full Name | 20th Street Clinic Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 105 N 20th St, Battle Creek, Michigan |
| Authorized Official Name and Position | Stephen Fedele (OWNER) |
| Authorized Official Contact | 2699696010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 20th Street Clinic Pc 105 N 20th St Battle Creek MI 49015-1746 Ph: (269) 969-6010 | 20th Street Clinic Pc 105 N 20th St Battle Creek MI 49015-1746 Ph: (269) 969-6010 |
| NPI Number | 1578744918 |
|---|---|
| Provider Enumeration Date | 11/14/2007 |
| Last Update Date | 03/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578744918 | NPI | - | NPPES |
| 080A310650 | Other | MI | BCBS |
| 111023860 | Medicaid | MI | |
| 464295 | Other | MI | ADVANTRA FREEDOM |
| CJ8333 | Other | RR MCR | |
| 010057408 | Other | RR MCR P-TAN | |
| 5130499 | Other | MEDICARE ADVANTAGE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5101004673 (Michigan) | Primary |
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