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945 9th St Lake Linden MI 49945-1100 | |
(906) 483-1030 | |
(906) 296-0521 |
Full Name | |
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Speciality | Family Medicine |
Location | 945 9th St, Lake Linden, Michigan |
Authorized Official Name and Position | James Bogan (CEO) |
Authorized Official Contact | 9064831500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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894 Campus Dr Ste. B Hancock MI 49930-1571 Ph: (906) 483-1128 | 945 9th St Lake Linden MI 49945-1100 Ph: (906) 483-1030 |
NPI Number | 1386970481 |
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Provider Enumeration Date | 10/23/2009 |
Last Update Date | 10/23/2009 |
Identifier | Type | State | Issuer |
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1386970481 | NPI | - | NPPES |
700C16002 | Other | MI | BCBSM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Michigan) | Primary |
Portage Physician Practices Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 945 9th St, Lake Linden, MI 49945 Phone: 906-483-1030 Fax: 906-296-0521 | |