BIRCH SHORE PRIMARY CARE PLLC NPI 1396609467

NPI Information

  • NPI: 1396609467
  • Provider Name: BIRCH SHORE PRIMARY CARE PLLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 3021 SCHOEDEL RD
    MANISTEE, MI
    ZIP 49660
  • Phone: (231) 397-9229

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NPI Details

BIRCH SHORE PRIMARY CARE PLLC is a primary care clinic center in Manistee, MI. BIRCH SHORE PRIMARY CARE PLLC NPI is 1396609467. The provider is registered as an organization entity type.

The provider's business location address is:

3021 SCHOEDEL RD
MANISTEE, MI
ZIP 49660-753
Phone: (231) 397-9229

The provider's authorized official is Charles Vandenberg .
The authorized official title is Physician/owner and has the following contact phone number (231) 397-9229.

The enumeration date for this NPI number is 12/12/2025 and was last updated on 12/13/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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