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Organization
MEMORIAL HOSPITAL
Active
Organization
MEMORIAL HOSPITAL
Active
Parent organization
MEMORIAL HOSPITAL
Other names
Memorial Medical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEMORIAL HOSPITAL
Authorized official
JORRI M TREMAIN (CFO)
(989) 729-4466
Entity
Organization
Contact information
Practice address
826 W KING ST, OWOSSO, MI 48867-2120
(989) 723-5211
(989) 723-9446
Mailing address
113 E WILLIAMS ST, OWOSSO, MI 48867-2360
(989) 725-6528
(989) 723-9446
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
1060000059
MI
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
NULL
207RH0003X
Hematology & Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
1060000059
MI
207X00000X
Orthopaedic Surgery Physician
1060000059
MI
207YS0123X
Facial Plastic Surgery Physician
1060000059
MI
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2083X0100X
Occupational Medicine Physician
—
NULL
2083X0100X
Occupational Medicine Physician
—
—
2084N0400X
Neurology Physician
1060000059
MI
208600000X
Surgery Physician
106000059
MI
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080G810270
BLUE CROSS BLUE SHIELD
MI
05
—
1316008006
—
MI
Enumeration date
12/13/2006
Last updated
09/21/2022
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