| Riverside Medical Clinic | |
|
203 Center St South Haven MI 49090-1311 | |
| (269) 637-2102 | |
| (269) 637-3783 |
| Full Name | Riverside Medical Clinic |
|---|---|
| Speciality | General Practice |
| Location | 203 Center St, South Haven, Michigan |
| Authorized Official Name and Position | James Sirajuddin (PRESIDENT) |
| Authorized Official Contact | 2696372102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Medical Clinic 203 Center St South Haven MI 49090-1311 Ph: (269) 637-2102 | Riverside Medical Clinic 203 Center St South Haven MI 49090-1311 Ph: (269) 637-2102 |
| NPI Number | 1609065358 |
|---|---|
| Provider Enumeration Date | 10/18/2007 |
| Last Update Date | 04/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609065358 | NPI | - | NPPES |
| 2111690 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 4301039518 (Michigan) | Primary |
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