| Alpine Family Medicine Plc | |
|
652 N Otsego Ave Gaylord MI 49735-2502 | |
| (989) 732-3529 | |
| (989) 732-7865 |
| Full Name | Alpine Family Medicine Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 652 N Otsego Ave, Gaylord, Michigan |
| Authorized Official Name and Position | Derek David Olson (MD/OWNER) |
| Authorized Official Contact | 9897323529 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpine Family Medicine Plc 652 N Otsego Ave Gaylord MI 49735-2502 Ph: (989) 732-3529 | Alpine Family Medicine Plc 652 N Otsego Ave Gaylord MI 49735-2502 Ph: (989) 732-3529 |
| NPI Number | 1174577720 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 01/06/2021 |
| Medicare PECOS PAC ID | 7214999770 |
|---|---|
| Medicare Enrollment ID | O20041028000119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174577720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | KK030249 (Michigan) | Primary |
| Provider Name | Derek David Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497796007 PECOS PAC ID: 1759343213 Enrollment ID: I20041029000096 |
| Provider Name | Ashley A Groters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225660285 PECOS PAC ID: 6507293859 Enrollment ID: I20200226000224 |
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