| Great Lakes Medical Clinic, Pllc | |
|
1850 Pipestone Rd Suite 102-b Benton Harbor MI 49022-2304 | |
| (269) 925-8386 | |
| (269) 925-4085 |
| Full Name | Great Lakes Medical Clinic, Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1850 Pipestone Rd, Benton Harbor, Michigan |
| Authorized Official Name and Position | Dawn Renee Schreckengust (PRESIDENT) |
| Authorized Official Contact | 2699258386 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Medical Clinic, Pllc 1850 Pipestone Rd Suite 102-b Benton Harbor MI 49022-2304 Ph: (269) 925-8386 | Great Lakes Medical Clinic, Pllc 1850 Pipestone Rd Suite 102-b Benton Harbor MI 49022-2304 Ph: (269) 925-8386 |
| NPI Number | 1669614152 |
|---|---|
| Provider Enumeration Date | 03/30/2009 |
| Last Update Date | 03/30/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669614152 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 5601002947 (Michigan) | Primary |
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