Basic Information
| Provider Information | |||||||||
| NPI: | 1679625875 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DAYONE FAMILY HEALTHCARE PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 363 FREMONT ST | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | BATTLE CREEK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490173389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2699696123 | ||||||||
| FaxNumber: | 2699696122 | ||||||||
| Practice Location | |||||||||
| Address1: | 363 FREMONT ST | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | BATTLE CREEK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490173389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2699696123 | ||||||||
| FaxNumber: | 2699696122 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2007 | ||||||||
| LastUpdateDate: | 02/20/2014 | ||||||||
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| AuthorizedOfficialLastName: | GALONSKY | ||||||||
| AuthorizedOfficialFirstName: | BRUCE | ||||||||
| AuthorizedOfficialMiddleName: | WEBER | ||||||||
| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2699696123 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 032967 | 01 | MI | BCN | OTHER | 102589658 | 05 | MI | MEDICAID | CA2277 | 01 | MI | MEDICARE RR GROUP | OTHER | 0801302811 | 01 | MI | BCBS | OTHER | 080185746 | 01 | MI | MEDICARE RR | OTHER | 104403915 | 05 | MI | MEDICAID | 0130281 | 01 | MI | BCN | OTHER | 0801329671 | 01 | MI | BCBS | OTHER | 080062297 | 01 | MI | MEDICARE RR | OTHER | 104654227 | 05 | MI | MEDICAID | P00245326 | 01 | MI | MEDICARE RR | OTHER | 0130348 | 01 | MI | BCN | OTHER | 080A310740 | 01 | MI | BCBS GROUP | OTHER | 0101303482 | 01 | MI | BCBS | OTHER |