| Shoreline Family Medicine Pc | |
|
5933 Grand Haven Rd Muskegon MI 49441-6011 | |
| (231) 799-3300 | |
| (231) 799-3322 |
| Full Name | Shoreline Family Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 5933 Grand Haven Rd, Muskegon, Michigan |
| Authorized Official Name and Position | Matthew N. Powell (PHYSICIAN) |
| Authorized Official Contact | 2317803300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoreline Family Medicine Pc 5933 Grand Haven Rd Muskegon MI 49441-6011 Ph: (231) 799-3300 | Shoreline Family Medicine Pc 5933 Grand Haven Rd Muskegon MI 49441-6011 Ph: (231) 799-3300 |
| NPI Number | 1417094459 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 05/05/2008 |
| Medicare PECOS PAC ID | 7012013162 |
|---|---|
| Medicare Enrollment ID | O20070507000116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417094459 | NPI | - | NPPES |
| 5610080 | Other | MI | BLUE CROSS |
| 4309931 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5101013736 (Michigan) | Primary |
| Provider Name | Matthew N Powell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154316222 PECOS PAC ID: 9537147665 Enrollment ID: I20040713001320 |
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