Michael Johnson, CRNA | |
14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | |
(231) 547-4024 | |
(231) 547-8088 |
Full Name | Michael Johnson |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 14700 Lake Shore Dr, Charlevoix, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114000668 | NPI | - | NPPES |
MJ223453 | Other | MI | BLUE SHIELD STATE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 4704223453 (Michigan) | Primary |
Entity Name | Mackinac Straits Health System Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659536035 PECOS PAC ID: 1456420876 Enrollment ID: O20080930000157 |
Entity Name | Sleepsmith Staffing Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114463379 PECOS PAC ID: 8325320369 Enrollment ID: O20170126001573 |
Mailing Address | Practice Location Address |
---|---|
Michael Johnson, CRNA 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 Ph: (231) 547-4024 | Michael Johnson, CRNA 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 Ph: (231) 547-4024 |
Michael C Macmillan, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 12375 Indian Place Dr, Charlevoix, MI 49720 Phone: 231-547-2496 Fax: 231-547-2823 | |
Mark Leroy Vanderweide, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 | |
Jennifer L Simons, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 | |
Mel Choponis, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 Fax: 231-547-8088 | |
Kenneth Forrester, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 Fax: 231-547-8088 | |
Madeline Jeakle Nemes, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 |