| NPI | 1063748770 |
|---|---|
| Doing Business As | PORTAGE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JAMES BOGAN CEO 906-483-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2009-10-30 |
| Last Update Date | 2009-10-30 |