Provider Demographics
NPI:1548336266
Name:CASEY, AMBER RAYNEE (DO)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:RAYNEE
Last Name:CASEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3245 HEALTH DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-1380
Mailing Address - Country:US
Mailing Address - Phone:269-552-2823
Mailing Address - Fax:269-552-2964
Practice Address - Street 1:3035 CAPITAL AVE SW
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4334
Practice Address - Country:US
Practice Address - Phone:269-565-9120
Practice Address - Fax:269-565-9125
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2025-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101013839207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1548336266Medicaid
MI1151300535OtherBLUE CROSS
MI1104840529OtherBCBSM - BRONSON
MI430660811Medicaid
MIM20520106 BRONSONMedicare PIN
MI1548336266Medicaid
H32960Medicare UPIN