| NPI | 1922248772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY ELLER Credentialing 231-672-2120 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2023-09-28 |