GREAT LAKES MEDICAL PC NPI 1942548946

NPI Information

NPI: 1942548946
Provider Name: GREAT LAKES MEDICAL PC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
1111 S MISSION ST
MOUNT PLEASANT, MI
ZIP 48858
Phone: (989) 773-9700
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GREAT LAKES MEDICAL PC is a rural health clinic center in Mount Pleasant, MI. GREAT LAKES MEDICAL PC NPI is 1942548946. The provider is registered as an organization entity type.

The provider's business location address is:

1111 S MISSION ST
MOUNT PLEASANT, MI
ZIP 48858-944
Phone: (989) 773-9700
Fax: (989) 779-9701

The provider's authorized official is Richard Wayne Macauley .
The authorized official title is Owner and has the following contact phone number (517) 449-2452.

The enumeration date for this NPI number is 1/25/2013 and was last updated on 12/27/2013.

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
1	261QR1300X	Clinic/Center	Rural Health	04411G	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	04411G	MEDICARE OSCAR/CERTIFICATION	MICHIGAN

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: 5/5/2024

NPI Synchronization or Removal

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