| C R Alderdice D O | |
|
1906 Langley Ave Saint Joseph MI 49085-1739 | |
| (269) 982-1722 | |
| Not Available |
| Full Name | C R Alderdice D O |
|---|---|
| Speciality | Family Medicine |
| Location | 1906 Langley Ave, Saint Joseph, Michigan |
| Authorized Official Name and Position | Charles Alderdice (PHYSICIAN) |
| Authorized Official Contact | 2699821722 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C R Alderdice D O 1906 Langley Ave Saint Joseph MI 49085-1739 Ph: (269) 982-1722 | C R Alderdice D O 1906 Langley Ave Saint Joseph MI 49085-1739 Ph: (269) 982-1722 |
| NPI Number | 1972807147 |
|---|---|
| Provider Enumeration Date | 01/03/2011 |
| Last Update Date | 01/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972807147 | NPI | - | NPPES |
| 1607063 | Medicaid | MI | |
| 5083312 | Other | AETNA PIN | |
| 5110022 | Other | MEDICARE PTAN | |
| 5110022 | Other | MI | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5101008526 (Michigan) | Primary |
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