Provider Demographics
NPI:1215344197
Name:ENGELMANN, BRIGITTE JACQUELINE (MD/PHD)
Entity type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:JACQUELINE
Last Name:ENGELMANN
Suffix:
Gender:F
Credentials:MD/PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4613 W MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-2698
Mailing Address - Country:US
Mailing Address - Phone:694-888-6722
Mailing Address - Fax:
Practice Address - Street 1:4613 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-2698
Practice Address - Country:US
Practice Address - Phone:269-488-8672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-12
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3473207R00000X, 390200000X
MI4301114295207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program