| Russell Van Houzen, Md, Plc | |
|
10161 E Pickwick Ct Suite E Traverse City MI 49684-5239 | |
| (231) 935-0888 | |
| (231) 935-0890 |
| Full Name | Russell Van Houzen, Md, Plc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10161 E Pickwick Ct, Traverse City, Michigan |
| Authorized Official Name and Position | Russell Neil Van Houzen (OWNER) |
| Authorized Official Contact | 2319350888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell Van Houzen, Md, Plc 10161 E Pickwick Ct Suite E Traverse City MI 49684-5239 Ph: (231) 935-0888 | Russell Van Houzen, Md, Plc 10161 E Pickwick Ct Suite E Traverse City MI 49684-5239 Ph: (231) 935-0888 |
| NPI Number | 1447460852 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447460852 | NPI | - | NPPES |
| 1096875 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301035319 (Michigan) | Primary |
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