# ASCENSION MEDICAL GROUP MICHIGAN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144436411
- **Authorized official:** RACHEL R PERRY (MANAGER)
- **Authorized official phone:** (248) 221-1918

## Contact information

- **Practice address:** 42645 GARFIELD RD, CLINTON TOWNSHIP, MI 48038-5022
- **Practice address phone:** (586) 228-4652
- **Mailing address:** PO BOX 14129, BELFAST, ME 04915-4032
- **Mailing address phone:** (248) 680-8000
- **Mailing address fax:** (248) 292-3852

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | MI | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | MI | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | MI | — |

## Other

- **Enumeration date:** 05/15/2007
- **Last updated:** 04/16/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0E01273 | BCBSM GROUP NUMBER | MI |