# PORTAGE PHYSICIAN PRACTICES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UP Medical Group - Portage Express Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164106910
- **Authorized official:** MONICA BOWMAN (PRESIDENT)
- **Authorized official phone:** (615) 920-7000

## Contact information

- **Practice address:** 56720 CALUMET AVE STE B, CALUMET, MI 49913-1967
- **Practice address phone:** (906) 481-8952
- **Practice address fax:** (906) 337-4049
- **Mailing address:** 330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
- **Mailing address phone:** (615) 920-7000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/12/2023
- **Last updated:** 10/12/2023