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2420 1st Ave S Escanaba MI 49829-1309 | |
(906) 786-1563 | |
(906) 786-8914 |
Full Name | |
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Speciality | Internal Medicine |
Location | 2420 1st Ave S, Escanaba, Michigan |
Authorized Official Name and Position | A. Gary Muller (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 9062254821 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4602 Dept Carol Stream IL 60122-0021 Ph: (906) 225-4821 | 2420 1st Ave S Escanaba MI 49829-1309 Ph: (906) 786-1563 |
NPI Number | 1336163799 |
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Provider Enumeration Date | 07/27/2006 |
Last Update Date | 04/27/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336163799 | NPI | - | NPPES |
0B11007 | Other | MI | BLUE CROSS BLUE SHIELD GR |
CB9574 | Other | MI | RAILROAD MEDICARE |
CC6305 | Other | MI | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 4301068941 (Michigan) | Primary |
Bright Star Enterprises, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4669 12th Rd, Escanaba, MI 49829 Phone: 906-786-9391 | |