| NPI | 1568002004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN LARAIA VP Ancillary Services 231-392-8410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2024-04-01 |