| Tom Tietjen Md Pllc | |
|
267 Creekside Dr Suite 200 Petoskey MI 49770-7609 | |
| (231) 753-2105 | |
| (231) 344-5923 |
| Full Name | Tom Tietjen Md Pllc |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 267 Creekside Dr, Petoskey, Michigan |
| Authorized Official Name and Position | Thomas Tietjen (MANAGER) |
| Authorized Official Contact | 2314395491 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tom Tietjen Md Pllc 859 Surrey Ln Petoskey MI 49770-9310 Ph: (231) 439-5491 | Tom Tietjen Md Pllc 267 Creekside Dr Suite 200 Petoskey MI 49770-7609 Ph: (231) 753-2105 |
| NPI Number | 1518360916 |
|---|---|
| Provider Enumeration Date | 09/30/2014 |
| Last Update Date | 12/12/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518360916 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 4301077247 (Michigan) | Primary |
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