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Organization
TRAVERSE BAY MEDICAL
Active
Organization
TRAVERSE BAY MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY LOUISE LOUDER D.O. (PRESIDENT)
(231) 933-8805
Entity
Organization
Contact information
Practice address
207 CIRCLE DR, TRAVERSE CITY, MI 49684-2347
(231) 933-8805
Mailing address
207 CIRCLE DR, TRAVERSE CITY, MI 49684-2347
(231) 933-8805
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101012165
MI
Other
Enumeration date
08/03/2008
Last updated
09/22/2008
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