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205 Osceola Street Laurium MI 49913-2134 | |
| (906) 337-6580 | |
| (906) 337-6562 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 205 Osceola Street, Laurium, Michigan |
| Authorized Official Name and Position | Jerry M Yang (SVP & CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7158472526 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
205 Osceola Street Laurium MI 49913-2134 Ph: (906) 337-6580 | 205 Osceola Street Laurium MI 49913-2134 Ph: (906) 337-6580 |
| NPI Number | 1205998713 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 06/06/2024 |
| Medicare PECOS PAC ID | 8123912011 |
|---|---|
| Medicare Enrollment ID | O20040211000763 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205998713 | NPI | - | NPPES |
| 00108 | Other | MI | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 238551 (Michigan) | Primary |
| Provider Name | David S Wood |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1619975869 PECOS PAC ID: 0042103210 Enrollment ID: I20040203000728 |
| Provider Name | Louis Joseph Mautone |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144294513 PECOS PAC ID: 4082508577 Enrollment ID: I20040216000104 |
| Provider Name | James R Galloway |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831151141 PECOS PAC ID: 1658368386 Enrollment ID: I20040426001825 |
| Provider Name | Matthew B Dewys |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427151083 PECOS PAC ID: 1456336205 Enrollment ID: I20040624000121 |
| Provider Name | Michael E Zevitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871543843 PECOS PAC ID: 4183602451 Enrollment ID: I20040713000030 |
| Provider Name | Jon D Paget |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326192311 PECOS PAC ID: 0648246363 Enrollment ID: I20040903000591 |
| Provider Name | Jon Maxwell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1487604542 PECOS PAC ID: 9739131657 Enrollment ID: I20050218000235 |
| Provider Name | Gary R Mikula |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831106749 PECOS PAC ID: 7810970431 Enrollment ID: I20050414001124 |
| Provider Name | Frederick D Rau |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1881657492 PECOS PAC ID: 8921041088 Enrollment ID: I20050610000136 |
| Provider Name | Joni A Meyers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518924448 PECOS PAC ID: 7719917368 Enrollment ID: I20050815000292 |
| Provider Name | Robert Allen Cook |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437220878 PECOS PAC ID: 4587697628 Enrollment ID: I20050920000074 |
| Provider Name | Dawn Renee Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184787772 PECOS PAC ID: 6709803315 Enrollment ID: I20051101001143 |
| Provider Name | Lawrence W Schenden |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609853605 PECOS PAC ID: 3779540869 Enrollment ID: I20051108000590 |
| Provider Name | Caroline Susanne Gwaltney |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780714337 PECOS PAC ID: 6507884228 Enrollment ID: I20051110000456 |
| Provider Name | Daryl M Lawrence Friedl |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124083365 PECOS PAC ID: 1951320548 Enrollment ID: I20051114000142 |
| Provider Name | Paul E Thielking |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346285335 PECOS PAC ID: 1557380599 Enrollment ID: I20051118000117 |
| Provider Name | Eric Andrew Maki |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073607156 PECOS PAC ID: 8921020348 Enrollment ID: I20051229000350 |
| Provider Name | Thomas F Sapp |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174540025 PECOS PAC ID: 3173546520 Enrollment ID: I20060111000775 |
| Provider Name | Frank Y Duncan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922048800 PECOS PAC ID: 5799753448 Enrollment ID: I20060117000754 |
| Provider Name | John E Kus |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487736203 PECOS PAC ID: 9335158310 Enrollment ID: I20060419000723 |
| Provider Name | Petio V Kotov |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1790731651 PECOS PAC ID: 2264443407 Enrollment ID: I20060601000009 |
| Provider Name | Jasmin J David |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073682134 PECOS PAC ID: 0143222851 Enrollment ID: I20070209000078 |
| Provider Name | Bryan S Judge |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255348173 PECOS PAC ID: 9436252079 Enrollment ID: I20070320000082 |
| Provider Name | Randy L Chilcote |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700894235 PECOS PAC ID: 4789788274 Enrollment ID: I20070322000094 |
| Provider Name | Gregory S Mervenne |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215955752 PECOS PAC ID: 3173522398 Enrollment ID: I20070409000266 |
| Provider Name | John P Deveau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437170198 PECOS PAC ID: 4688779960 Enrollment ID: I20070416000061 |
| Provider Name | Cynthia Kay Rubert |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1023074960 PECOS PAC ID: 7517068331 Enrollment ID: I20070724000501 |
| Provider Name | Darlene Daly |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093712457 PECOS PAC ID: 6204926157 Enrollment ID: I20071217000254 |
| Provider Name | Joshua D Vanderlugt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407079536 PECOS PAC ID: 7113008814 Enrollment ID: I20080119000105 |
| Provider Name | Mark Aidan Kelley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1851303978 PECOS PAC ID: 3173512423 Enrollment ID: I20080516000458 |
| Provider Name | Patricia G Koskiniemi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437183712 PECOS PAC ID: 1254400112 Enrollment ID: I20080519000083 |
| Provider Name | Deborah K Gruver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801911342 PECOS PAC ID: 7719053370 Enrollment ID: I20080904000505 |
| Provider Name | Hershel S Moss |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407920911 PECOS PAC ID: 2668379660 Enrollment ID: I20081018000203 |
| Provider Name | David William Farhat |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285690230 PECOS PAC ID: 7810058799 Enrollment ID: I20081210000686 |
| Provider Name | Mark T Hoffmann |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356342034 PECOS PAC ID: 8527966803 Enrollment ID: I20090114000396 |
| Provider Name | Brian Stephen Videan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568614386 PECOS PAC ID: 9638234800 Enrollment ID: I20090223000442 |
| Provider Name | Nathan D Mcparlan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073656955 PECOS PAC ID: 3173680089 Enrollment ID: I20090320000203 |
| Provider Name | Marcus Ma |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336102847 PECOS PAC ID: 2961315072 Enrollment ID: I20090401000366 |
| Provider Name | Keith A. Heslinger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275540718 PECOS PAC ID: 1153318936 Enrollment ID: I20090422000515 |
| Provider Name | Steven P Phillipson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023034105 PECOS PAC ID: 0345141313 Enrollment ID: I20090608000496 |
| Provider Name | Marilyn S Dewald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548262702 PECOS PAC ID: 0143370452 Enrollment ID: I20090609000035 |
| Provider Name | Vinson Consolacion Ulep |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013149707 PECOS PAC ID: 7315093655 Enrollment ID: I20090929000009 |
| Provider Name | Robert H Blotter |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861403719 PECOS PAC ID: 7214954957 Enrollment ID: I20091110000664 |
| Provider Name | Shannon I Handler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326291576 PECOS PAC ID: 1850432097 Enrollment ID: I20100109000151 |
| Provider Name | David T Callaghan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851629117 PECOS PAC ID: 7911041710 Enrollment ID: I20100217000417 |
| Provider Name | Jeffrey D Baril |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588992788 PECOS PAC ID: 6507900305 Enrollment ID: I20100217000472 |
| Provider Name | Timothy N Logemann |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1184626053 PECOS PAC ID: 2163320441 Enrollment ID: I20100306000043 |
| Provider Name | Paul A Luetmer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689675332 PECOS PAC ID: 9133027410 Enrollment ID: I20100306000107 |
| Provider Name | Steven Woodworth |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073677803 PECOS PAC ID: 5092840199 Enrollment ID: I20100315000562 |
| Provider Name | Stanley B Beckman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750431722 PECOS PAC ID: 8022906734 Enrollment ID: I20100624000344 |
| Provider Name | Martin Paul Freeman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790703114 PECOS PAC ID: 7113059015 Enrollment ID: I20100712000665 |
| Provider Name | Melissa A Barton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427018225 PECOS PAC ID: 8325121171 Enrollment ID: I20100723000958 |
| Provider Name | Khalil A Attie |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235185901 PECOS PAC ID: 6800929134 Enrollment ID: I20100806000070 |
| Provider Name | Matthew R Frantz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508186065 PECOS PAC ID: 4486849023 Enrollment ID: I20101109001157 |
| Provider Name | William Douglas Tressel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174785505 PECOS PAC ID: 7113106584 Enrollment ID: I20110201000433 |
| Provider Name | Laura M Lane |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497737217 PECOS PAC ID: 1254511504 Enrollment ID: I20110203001063 |
| Provider Name | Corin S Swartz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518268259 PECOS PAC ID: 3476734211 Enrollment ID: I20110225000855 |
| Provider Name | Kirk R Klemme |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609836139 PECOS PAC ID: 7416943501 Enrollment ID: I20110311000097 |
| Provider Name | Adnan A Malik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942470042 PECOS PAC ID: 0749463289 Enrollment ID: I20110322000316 |
| Provider Name | Zuhair Ghanem |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1649474099 PECOS PAC ID: 8426229741 Enrollment ID: I20110919000255 |
| Provider Name | Jerry Russel Hill |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821099060 PECOS PAC ID: 7618138579 Enrollment ID: I20120419000788 |
| Provider Name | Jonathan N Brueggeman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1790836401 PECOS PAC ID: 7719045566 Enrollment ID: I20120430000711 |
| Provider Name | John Lightfoot |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740348127 PECOS PAC ID: 0547291502 Enrollment ID: I20121020000036 |
| Provider Name | Benjamin Abadeer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255541603 PECOS PAC ID: 9335399641 Enrollment ID: I20121023000391 |
| Provider Name | Shalini Johnson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1629287040 PECOS PAC ID: 2365622388 Enrollment ID: I20130226000534 |
| Provider Name | Tracey A Marino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801137229 PECOS PAC ID: 3870738776 Enrollment ID: I20130326000022 |
| Provider Name | Nickole Bazger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609031202 PECOS PAC ID: 3173796794 Enrollment ID: I20130509000272 |
| Provider Name | John Pietila |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841450772 PECOS PAC ID: 9133353014 Enrollment ID: I20131008001305 |
| Provider Name | Melissa K Aste |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447525407 PECOS PAC ID: 8820259161 Enrollment ID: I20140205001158 |
| Provider Name | Christiann A Rosemurgy |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1104236256 PECOS PAC ID: 4082830880 Enrollment ID: I20140731001999 |
| Provider Name | Michael Mcallister |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386874022 PECOS PAC ID: 2466671821 Enrollment ID: I20140917000120 |
| Provider Name | Kasey Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235541053 PECOS PAC ID: 7618290099 Enrollment ID: I20141217000333 |
| Provider Name | Sarah M Verberkmoes |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629475918 PECOS PAC ID: 5294058780 Enrollment ID: I20150109000209 |
| Provider Name | Heather K Nyman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588925101 PECOS PAC ID: 9234394313 Enrollment ID: I20150204002292 |
| Provider Name | James R Black |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871661868 PECOS PAC ID: 9436474731 Enrollment ID: I20150209000657 |
| Provider Name | Derek J Bustos |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518355494 PECOS PAC ID: 0345565594 Enrollment ID: I20150210000258 |
| Provider Name | Beth A Cook |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1174914014 PECOS PAC ID: 4880910033 Enrollment ID: I20150305000514 |
| Provider Name | Thomas D Boostrom |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164773685 PECOS PAC ID: 7810147931 Enrollment ID: I20150420000095 |
| Provider Name | Amber L Kokkonen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558770495 PECOS PAC ID: 6709108947 Enrollment ID: I20150708003075 |
| Provider Name | Edgar Betancourt |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1174593875 PECOS PAC ID: 4880691898 Enrollment ID: I20150723008561 |
| Provider Name | Eric W Toth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205247665 PECOS PAC ID: 4082834924 Enrollment ID: I20150804003313 |
| Provider Name | Peter L Skellenger |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1003288531 PECOS PAC ID: 9537462700 Enrollment ID: I20160121001191 |
| Provider Name | Scott Kantola |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1326211384 PECOS PAC ID: 4880840362 Enrollment ID: I20160204001439 |
| Provider Name | Stephanie Lynn Videan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669800975 PECOS PAC ID: 3971809492 Enrollment ID: I20160309002715 |
| Provider Name | Tatyana Bombard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255629861 PECOS PAC ID: 0941595748 Enrollment ID: I20160818000112 |
| Provider Name | Carlos X Condado |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205028768 PECOS PAC ID: 2860478690 Enrollment ID: I20160823000843 |
| Provider Name | Michael J Olson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891062592 PECOS PAC ID: 0941466585 Enrollment ID: I20170111002795 |
| Provider Name | Andrew S Khan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750330932 PECOS PAC ID: 1052224375 Enrollment ID: I20170113001267 |
| Provider Name | Jessica L Harju |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558713891 PECOS PAC ID: 0547542441 Enrollment ID: I20170130002492 |
| Provider Name | Craig Hamilton Barstow |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215114160 PECOS PAC ID: 1557599008 Enrollment ID: I20170208000449 |
| Provider Name | Eric Adam Fine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639445125 PECOS PAC ID: 7214249416 Enrollment ID: I20170404000480 |
| Provider Name | Jason Nathaniel Butler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023350899 PECOS PAC ID: 2264734375 Enrollment ID: I20170510001466 |
| Provider Name | Olga G Dewald |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710397690 PECOS PAC ID: 2264734631 Enrollment ID: I20170609000955 |
| Provider Name | Cynthia A Beale |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1821273350 PECOS PAC ID: 7810071560 Enrollment ID: I20170707002593 |
| Provider Name | Jeremy Zarski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396194049 PECOS PAC ID: 7315210606 Enrollment ID: I20170908000149 |
| Provider Name | Kristen Tweedy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1891133559 PECOS PAC ID: 1759522568 Enrollment ID: I20171004003491 |
| Provider Name | Shefiu O Shittu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154646727 PECOS PAC ID: 5799977401 Enrollment ID: I20171128002621 |
| Provider Name | Megan S Luttrell |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1417140278 PECOS PAC ID: 0143588533 Enrollment ID: I20171212001681 |
| Provider Name | Emmanuel O Nwadike |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962686485 PECOS PAC ID: 1456407618 Enrollment ID: I20171218003372 |
| Provider Name | Rebecca Rae Ulep |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114186426 PECOS PAC ID: 7214159672 Enrollment ID: I20180109000506 |
| Provider Name | Annamaria T Church |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669452371 PECOS PAC ID: 8325114606 Enrollment ID: I20180124000293 |
| Provider Name | Gayle J Maslakow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275031015 PECOS PAC ID: 4688934029 Enrollment ID: I20180205000875 |
| Provider Name | Albert D Penney |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083680847 PECOS PAC ID: 2961305404 Enrollment ID: I20180213002198 |
| Provider Name | Dana Lynn Leannah |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245504562 PECOS PAC ID: 8921369232 Enrollment ID: I20180301001799 |
| Provider Name | Clint R Pakkala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326548157 PECOS PAC ID: 2860755832 Enrollment ID: I20180405000267 |
| Provider Name | Oneica N Poole |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508132622 PECOS PAC ID: 8426334244 Enrollment ID: I20180405000325 |
| Provider Name | Katie M Bittner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700226982 PECOS PAC ID: 9739486408 Enrollment ID: I20180412002241 |
| Provider Name | Elisabeth D Tucker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497742977 PECOS PAC ID: 9830117589 Enrollment ID: I20180416001468 |
| Provider Name | Jeffrey Hyland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023042504 PECOS PAC ID: 4486614450 Enrollment ID: I20180712001035 |
| Provider Name | Andrew Beaumont |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1871688135 PECOS PAC ID: 6305910134 Enrollment ID: I20180806002647 |
| Provider Name | Stephen I Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912105057 PECOS PAC ID: 5294986840 Enrollment ID: I20180811000034 |
| Provider Name | Erin Angela Mcintyre |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225533979 PECOS PAC ID: 3476805375 Enrollment ID: I20181009002828 |
| Provider Name | Jordan William Abel |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1417273301 PECOS PAC ID: 4789806522 Enrollment ID: I20181010002289 |
| Provider Name | Kristen Meske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215416656 PECOS PAC ID: 2769726280 Enrollment ID: I20181210002081 |
| Provider Name | Baochong B Chang |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1790851525 PECOS PAC ID: 8325021652 Enrollment ID: I20190416002176 |
| Provider Name | Colleen M Dupuis |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1356661011 PECOS PAC ID: 9335369776 Enrollment ID: I20190529002968 |
| Provider Name | Rachel Laszko |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568876621 PECOS PAC ID: 5698992121 Enrollment ID: I20190612002981 |
| Provider Name | Allison K Harr |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1205140761 PECOS PAC ID: 4486989662 Enrollment ID: I20190710001831 |
| Provider Name | Brett Michael Gervais |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144888769 PECOS PAC ID: 9931431400 Enrollment ID: I20191101002042 |
| Provider Name | Bhavesh Amin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639690175 PECOS PAC ID: 9537430111 Enrollment ID: I20191105000253 |
| Provider Name | Hamilton J Wells |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225237944 PECOS PAC ID: 1759420581 Enrollment ID: I20200110000115 |
| Provider Name | Darin A Hoiska |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508401886 PECOS PAC ID: 5597191239 Enrollment ID: I20200129000271 |
| Provider Name | Jeremy M Nicoski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336786078 PECOS PAC ID: 0345677985 Enrollment ID: I20200220003068 |
| Provider Name | Yewande Oladipo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053775429 PECOS PAC ID: 0345532586 Enrollment ID: I20200424000673 |
| Provider Name | Tina M Ploe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952951485 PECOS PAC ID: 2062843634 Enrollment ID: I20200514002054 |
| Provider Name | Matthew S Mcrae |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013440684 PECOS PAC ID: 3971873498 Enrollment ID: I20200702001364 |
| Provider Name | Tom D Raisanen |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1124481544 PECOS PAC ID: 5799071817 Enrollment ID: I20200723003141 |
| Provider Name | Amy Nielsen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356736995 PECOS PAC ID: 5496057655 Enrollment ID: I20200928002153 |
| Provider Name | Emmett Mosley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770783086 PECOS PAC ID: 5597737270 Enrollment ID: I20201116000606 |
| Provider Name | Shirin Sultana |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053610691 PECOS PAC ID: 7416266846 Enrollment ID: I20210106002658 |
| Provider Name | Brett C Kodish |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093128944 PECOS PAC ID: 7911226444 Enrollment ID: I20210203000952 |
| Provider Name | Meredith E Caudill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609461789 PECOS PAC ID: 9638588775 Enrollment ID: I20210503000504 |
| Provider Name | Mandy Rutter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063781623 PECOS PAC ID: 2860650066 Enrollment ID: I20210528001086 |
| Provider Name | Hector Manuel Cabeza |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790942688 PECOS PAC ID: 1456544774 Enrollment ID: I20210618000657 |
| Provider Name | Craig Thomas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104319946 PECOS PAC ID: 6901152115 Enrollment ID: I20210701001180 |
| Provider Name | Ahmed F Mohammed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407231178 PECOS PAC ID: 1557619913 Enrollment ID: I20210805000104 |
| Provider Name | Kurt D Ammerman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780023655 PECOS PAC ID: 2365685179 Enrollment ID: I20210831000950 |
| Provider Name | Brittany Penegor |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770105991 PECOS PAC ID: 6406252543 Enrollment ID: I20210915000701 |
| Provider Name | Ryon Edward Hokens |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881985679 PECOS PAC ID: 5395143119 Enrollment ID: I20211008001775 |
| Provider Name | Susan Rice |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851316301 PECOS PAC ID: 5395894216 Enrollment ID: I20211014002192 |
| Provider Name | Kristen M Jahn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013977537 PECOS PAC ID: 5395795843 Enrollment ID: I20211215002222 |
| Provider Name | Tom T Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922389048 PECOS PAC ID: 0941578736 Enrollment ID: I20220113000222 |
| Provider Name | Jared Laverne Harwood |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942393954 PECOS PAC ID: 7113161225 Enrollment ID: I20220211001378 |
| Provider Name | Lara Briseno Kenney |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1083688584 PECOS PAC ID: 5395928550 Enrollment ID: I20220718000968 |
| Provider Name | Karen Lynn Macdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013652080 PECOS PAC ID: 5890177695 Enrollment ID: I20220726002168 |
| Provider Name | Beau P Dupuis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053058347 PECOS PAC ID: 8123400280 Enrollment ID: I20220805001461 |
| Provider Name | Terry Marie Anderson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1003998915 PECOS PAC ID: 7113300492 Enrollment ID: I20220818003259 |
| Provider Name | Austin Mackenzie |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407419591 PECOS PAC ID: 3375878531 Enrollment ID: I20220823001309 |
| Provider Name | Jannel Carandang Fink |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386133486 PECOS PAC ID: 2567846330 Enrollment ID: I20220827000045 |
| Provider Name | Akachi Azubuike |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467867762 PECOS PAC ID: 0941511471 Enrollment ID: I20220913002895 |
| Provider Name | Jacek Olszewski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518431832 PECOS PAC ID: 1355726076 Enrollment ID: I20220916001160 |
| Provider Name | Jordan A Fuller |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386266211 PECOS PAC ID: 0446636203 Enrollment ID: I20220930001593 |
| Provider Name | Megan Lynn Jacobs |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053783217 PECOS PAC ID: 6103293972 Enrollment ID: I20221108000788 |
| Provider Name | Daniel Galban |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215432661 PECOS PAC ID: 4284036153 Enrollment ID: I20221117001125 |
| Provider Name | William Y Ansa Otu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346564168 PECOS PAC ID: 2365635208 Enrollment ID: I20230113000868 |
| Provider Name | Judith Jennings |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1538240080 PECOS PAC ID: 5496149338 Enrollment ID: I20230313001987 |
| Provider Name | Abdullahi Mahgoub |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093371999 PECOS PAC ID: 1951767987 Enrollment ID: I20230517003362 |
| Provider Name | Mary L Stoffel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437111036 PECOS PAC ID: 1254336753 Enrollment ID: I20230620002039 |
| Provider Name | Blake Dupuis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588355739 PECOS PAC ID: 4688034002 Enrollment ID: I20230718000186 |
| Provider Name | Christopher Niehues |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518453448 PECOS PAC ID: 7315296357 Enrollment ID: I20230721001801 |
| Provider Name | Jaime Oswald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366063216 PECOS PAC ID: 3375966419 Enrollment ID: I20230901001495 |
| Provider Name | Laura Elizabeth Sowatsky |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639843436 PECOS PAC ID: 6709232200 Enrollment ID: I20231019000774 |
| Provider Name | Piersan Elizabeth Suriano Williams |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598546814 PECOS PAC ID: 3971950999 Enrollment ID: I20231114000622 |
| Provider Name | Laura Polakowski |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679945844 PECOS PAC ID: 6901254036 Enrollment ID: I20231129002465 |
| Provider Name | Judy Ungerleider Hennessey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811069669 PECOS PAC ID: 7214913938 Enrollment ID: I20231207003468 |
| Provider Name | Keane Mccullum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841793510 PECOS PAC ID: 2466801709 Enrollment ID: I20231212000768 |
| Provider Name | Jason Heese |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1093860132 PECOS PAC ID: 7618009945 Enrollment ID: I20231228003771 |
| Provider Name | Ruth Mahmood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659518199 PECOS PAC ID: 9234322900 Enrollment ID: I20240322002092 |
| Provider Name | Kay Johnson-keys |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043247190 PECOS PAC ID: 4587621271 Enrollment ID: I20240507000486 |
| Provider Name | Thomas Campbell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285610774 PECOS PAC ID: 2062305246 Enrollment ID: I20240611002187 |
| Provider Name | Helen Domitrovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205677994 PECOS PAC ID: 3072050574 Enrollment ID: I20240801002936 |
| Provider Name | Kristi Lynn Wegener |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497131452 PECOS PAC ID: 7214332204 Enrollment ID: I20240821004021 |
| Provider Name | Alfred Imbody |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215057914 PECOS PAC ID: 1658453485 Enrollment ID: I20240826001168 |
| Provider Name | John Whitney Rajala |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265069132 PECOS PAC ID: 7315487832 Enrollment ID: I20240911002691 |
| Provider Name | Manisha Shah |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215012000 PECOS PAC ID: 7517120124 Enrollment ID: I20241001000671 |
| Provider Name | Amier Ahmad |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689061897 PECOS PAC ID: 8224359807 Enrollment ID: I20241008001407 |
| Provider Name | Alan Berger |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1104861350 PECOS PAC ID: 6709887656 Enrollment ID: I20241010002770 |
| Provider Name | Nancy Rihana |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1982835237 PECOS PAC ID: 5294954699 Enrollment ID: I20241101002458 |
| Provider Name | Monica Cespedes Santana |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1114204161 PECOS PAC ID: 7214212653 Enrollment ID: I20241104000770 |
| Provider Name | Salman Mandhai |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639445166 PECOS PAC ID: 4981914538 Enrollment ID: I20241104003351 |
| Provider Name | Sandra L. Coppo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245057611 PECOS PAC ID: 5890229306 Enrollment ID: I20241106002441 |
| Provider Name | Jeanie Renee Henrion |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639662646 PECOS PAC ID: 3779017199 Enrollment ID: I20241107003289 |
| Provider Name | Rania Saleh |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1326280264 PECOS PAC ID: 8022265685 Enrollment ID: I20241111000984 |
| Provider Name | Ravindran Padmanabhan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1730114943 PECOS PAC ID: 5799727616 Enrollment ID: I20241120001149 |
| Provider Name | Andrea Caballero |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1003173824 PECOS PAC ID: 3274841770 Enrollment ID: I20241121002227 |
| Provider Name | Jasdeep Dalawari |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215986807 PECOS PAC ID: 1759275167 Enrollment ID: I20241125004066 |
| Provider Name | Lauren Fiske |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1952509796 PECOS PAC ID: 8426270018 Enrollment ID: I20241127000978 |
Aspirus Keweenaw Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Osceola St, Laurium, MI 49913 Phone: 906-337-6580 Fax: 906-337-6582 | |
Aspirus Keweenaw Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Osceola St, Laurium, MI 49913 Phone: 906-337-6500 Fax: 906-337-6597 |