# MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Munson Healthcare Petoskey Community Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174313852
- **Authorized official:** MICHAEL FRYE MD (PRES AMBULATORY & BUS DEVELOPMENT)
- **Authorized official phone:** (704) 458-8010

## Contact information

- **Practice address:** 1619 ANDERSON RD, PETOSKEY, MI 49770-9256
- **Practice address phone:** (231) 417-6000
- **Practice address fax:** (231) 417-6005
- **Mailing address:** 1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/07/2025
- **Last updated:** 04/17/2026