Mi Primary Care, Pllc | |
4950 E Blue Grass Rd Mt Pleasant MI 48858-6020 | |
(989) 817-4640 | |
(833) 974-2264 |
Full Name | Mi Primary Care, Pllc |
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Speciality | Clinic/Center |
Location | 4950 E Blue Grass Rd, Mt Pleasant, Michigan |
Authorized Official Name and Position | Roberta S Hahn (MANAGER) |
Authorized Official Contact | 9893034101 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mi Primary Care, Pllc 4950 E Blue Grass Rd Mt Pleasant MI 48858-6020 Ph: (989) 817-4640 | Mi Primary Care, Pllc 4950 E Blue Grass Rd Mt Pleasant MI 48858-6020 Ph: (989) 817-4640 |
NPI Number | 1104441302 |
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Provider Enumeration Date | 06/12/2020 |
Last Update Date | 11/10/2023 |
Medicare PECOS PAC ID | 4486070489 |
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Medicare Enrollment ID | O20200821000464 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104441302 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Jose L Raygada |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1063623981 PECOS PAC ID: 4587716824 Enrollment ID: I20090716000468 |
Provider Name | Larry M Bennett |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1134132038 PECOS PAC ID: 6800067836 Enrollment ID: I20110922000272 |
Provider Name | Roberta S Hahn |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770936866 PECOS PAC ID: 5799078721 Enrollment ID: I20160727002618 |
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