| Fowlerville Medical Center, Plc | |
|
202 E Van Riper Rd Suite 100 Fowlerville MI 48836-7947 | |
| (517) 223-7900 | |
| (517) 223-7635 |
| Full Name | Fowlerville Medical Center, Plc |
|---|---|
| Speciality | Family Medicine |
| Location | 202 E Van Riper Rd, Fowlerville, Michigan |
| Authorized Official Name and Position | Norine M Tracy (OWNER) |
| Authorized Official Contact | 5172237900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fowlerville Medical Center, Plc 202 E Van Riper Rd Suite 100 Fowlerville MI 48836-7947 Ph: (517) 223-7900 | Fowlerville Medical Center, Plc 202 E Van Riper Rd Suite 100 Fowlerville MI 48836-7947 Ph: (517) 223-7900 |
| NPI Number | 1033290796 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 01/31/2022 |
| Medicare PECOS PAC ID | 8729038518 |
|---|---|
| Medicare Enrollment ID | O20050128000895 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033290796 | NPI | - | NPPES |
| 0477259 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301060017 (Michigan) | Primary |
| Provider Name | Norine M Tracy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982609202 PECOS PAC ID: 4880644681 Enrollment ID: I20050824000369 |
Fowlerville Family Practice Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 775 South Grand Avenue, Fowlerville, MI 48836 Phone: 517-223-7800 Fax: 517-223-7814 |