Provider Demographics
NPI:1679625875
Name:DAYONE FAMILY HEALTHCARE PC
Entity type:Organization
Organization Name:DAYONE FAMILY HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:WEBER
Authorized Official - Last Name:GALONSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-969-6123
Mailing Address - Street 1:363 FREMONT ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3389
Mailing Address - Country:US
Mailing Address - Phone:269-969-6123
Mailing Address - Fax:269-969-6122
Practice Address - Street 1:363 FREMONT ST
Practice Address - Street 2:SUITE 203
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3389
Practice Address - Country:US
Practice Address - Phone:269-969-6123
Practice Address - Fax:269-969-6122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI032967OtherBCN
MI102589658Medicaid
MICA2277OtherMEDICARE RR GROUP
MI0801302811OtherBCBS
MI080185746OtherMEDICARE RR
MI104403915Medicaid
MI0130281OtherBCN
MI0801329671OtherBCBS
MI080062297OtherMEDICARE RR
MI104654227Medicaid
MIP00245326OtherMEDICARE RR
MI0130348OtherBCN
MI080A310740OtherBCBS GROUP
MI0101303482OtherBCBS
MI0801302811OtherBCBS
MICA2277OtherMEDICARE RR GROUP
MI0130281OtherBCN
MI0801329671OtherBCBS
MIP01470004Medicare ID - Type Unspecified