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15146 16th Ave, Marne, MI 49435-9605 | |
(616) 288-6970 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Internal Medicine - Addiction Medicine |
Location | 15146 16th Ave, Marne, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1598437642 | NPI | - | NPPES |
Provider Name | Gilbert A Masterson |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1497740930 PECOS PAC ID: 3375635006 Enrollment ID: I20070824000761 |
Provider Name | Kelly J Culmore |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841760972 PECOS PAC ID: 9537555727 Enrollment ID: I20220418000382 |
Provider Name | Nina J Deane |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932814787 PECOS PAC ID: 3971940511 Enrollment ID: I20240319002243 |
Mailing Address | Practice Location Address |
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15146 16th Ave, Marne, MI 49435-9605 Ph: () - | 15146 16th Ave, Marne, MI 49435-9605 Ph: (616) 288-6970 |