| Soma Medical Clinic, Llc | |
|
955 S Bailey Ave South Haven MI 49090-6743 | |
| (269) 637-5271 | |
| (269) 639-2919 |
| Full Name | Soma Medical Clinic, Llc |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 955 S Bailey Ave, South Haven, Michigan |
| Authorized Official Name and Position | Angie Oetman (MEDICAL STAFF COORDINATOR) |
| Authorized Official Contact | 2696392807 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soma Medical Clinic, Llc 955 S Bailey Ave South Haven MI 49090-6743 Ph: (269) 637-5271 | Soma Medical Clinic, Llc 955 S Bailey Ave South Haven MI 49090-6743 Ph: (269) 637-5271 |
| NPI Number | 1952494353 |
|---|---|
| Provider Enumeration Date | 09/30/2006 |
| Last Update Date | 04/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952494353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 042007627 (Illinois) | Secondary |
| 282N00000X | General Acute Care Hospital | 4301102383 (Michigan) | Primary |
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