Dr. Brent A Medema
Endodontist
9021 N Rodgers Ct Se Suite E
Caledonia
, Michigan 49316-7649
Dr. Brent A Medema
Endodontist
9021 N Rodgers Ct Se Suite E
Caledonia
, Michigan 49316-7649
(269) 760-5505
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About
Features
Specialties
- Endodontist
Languages spoken
- English
Location
First Address
- Dr. Brent A Medema
- 7090 Hickory Point Dr
- Portage, MI
- Zip : 49024-4039
- Phone : (269) 760-5505
Second Address
- Dr. Brent A Medema
- 9021 N Rodgers Ct Se Suite E
- Caledonia, MI
- Zip : 49316-7649
- Phone : (616) 891-1400
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223E0200X | Endodontist | 2901021310 | MI |
National Provider Identifier
| NPI | 1043628670 |
|---|---|
| Provider Name | Dr. Brent A Medema |
| First Address | Portage, MI 49024-4039 |
| Second Address | Caledonia, MI 49316-7649 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/07/2014 |
| Last Update Date | 28/07/2014 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.