Pine Trees Medical Office Pc | |
11610 Waldron Rd Jerome MI 49249-9637 | |
(517) 688-4842 | |
(517) 688-4842 |
Full Name | Pine Trees Medical Office Pc |
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Speciality | Internal Medicine |
Location | 11610 Waldron Rd, Jerome, Michigan |
Authorized Official Name and Position | Roy W Boyer (PRESIDENT) |
Authorized Official Contact | 5176884842 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Pine Trees Medical Office Pc 11610 Waldron Rd Jerome MI 49249-9637 Ph: (517) 688-4842 | Pine Trees Medical Office Pc 11610 Waldron Rd Jerome MI 49249-9637 Ph: (517) 688-4842 |
NPI Number | 1487648374 |
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Provider Enumeration Date | 09/07/2005 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487648374 | NPI | - | NPPES |
P41335 | Other | MI | BLUE CARE NETWORK HMO |
1 106914130 | Other | MI | BCBS |
4462854 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 4301028315 (Michigan) | Primary |