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Contact Information

LANCE L PRIDE, PA
601 JOHN ST STE M-460
KALAMAZOO, MI49007-5355
 Phone: 269-341-7333
 Fax: 269-341-7371
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for LANCE L PRIDE · (Male)

NPI # 1437432036
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 09/21/2011
Last updated 11/27/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 5601006118
  • VA Medicaid 14374322036
  • VA Other VV9406A MEDICARE PTAN
  • VA Other 10111084P SENTARA HEALTH PLANS
  • VA Other 14374322036 TRICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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