Female

Desmonda B. Wixson MD

Internal Medicine Physician in Kalamazoo, MI(View on Map)

Full Name

Desmonda Brady Wixson MD

NPI Number

1013947522

NPI Type

Individual Provider

Gender

Female

Enumeration Date

07/03/2006

Specialties

(Taxonomies)

Code

207R00000X
208000000X

Primary Taxonomy

Yes
No

Licenses

State

Michigan

License Number

4301072883

Contact
Information

Purpose

Mailing
Location

Address

4613 W MAIN ST STE A
4613 W MAIN ST STE A

City

Kalamazoo
Kalamazoo

State

MI
MI

Postal Code

49006-2698
49006-2698

Country

US
US

Telephone Number

(269) 488-8672
(269) 488-8672

Identifiers

Identifier

4605400

Identifier State

MI

Identifier Issuer

Unknown

Health Information Exchange

Endpoint Type

DIRECT

Endpoint

direct@direct.bronsonhg.org

Endpoint Description

Bronson Healthcare Group Direct address

Use

Direct

Content Type

Other

Other Description:
Continuity of Care Document

Affiliation

Y

Endpoint Location

Bronson Healthcare Group601 John StKalamazoo, MI490075341US

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/07/2022

Provider Address

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