# MIDLAND GENERAL PRACTICE PC

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

## Provider details

- **NPI number:** 1306863204
- **Authorized official:** MRS. DEBRA B HELM BA (OFFICE MANAGER)
- **Authorized official phone:** (989) 832-8803

## Contact information

- **Practice address:** 901 E INDIAN ST, MIDLAND, MI 48640-5397
- **Practice address phone:** (989) 832-8803
- **Practice address fax:** (989) 832-4134
- **Mailing address:** 901 E INDIAN ST, MIDLAND, MI 48640-5397
- **Mailing address phone:** (989) 832-8803
- **Mailing address fax:** (989) 832-4134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | JV005853 | MI | Yes |

## Other

- **Enumeration date:** 07/16/2006
- **Last updated:** 04/14/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0155628580 | BLUE CROSS BLUE SHIELD | MI |
| 05 | — | 2991184 | — | MI |