| Up Telehealth, Llc | |
|
228 W Washington St Ste 7 Marquette MI 49855-4330 | |
| (734) 692-5855 | |
| (734) 241-0014 |
| Full Name | Up Telehealth, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 228 W Washington St Ste 7, Marquette, Michigan |
| Authorized Official Name and Position | Ann Swartout (BILLING MANAGER) |
| Authorized Official Contact | 7342413891 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Up Telehealth, Llc 228 W Washington St Ste 7 Marquette MI 49855-4330 Ph: (734) 692-5855 | Up Telehealth, Llc 228 W Washington St Ste 7 Marquette MI 49855-4330 Ph: (734) 692-5855 |
| NPI Number | 1538767678 |
|---|---|
| Provider Enumeration Date | 10/12/2020 |
| Last Update Date | 10/12/2020 |
| Certification Date | 10/12/2020 |
| Medicare PECOS PAC ID | 0749693307 |
|---|---|
| Medicare Enrollment ID | O20201229001097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538767678 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | William J Medick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669577201 PECOS PAC ID: 3375572852 Enrollment ID: I20100628000928 |
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