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Organization
TRAVERSE BAY HOSPITALISTS, PLLC
Active
Organization
TRAVERSE BAY HOSPITALISTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER VIDEAN (PROVIDER ENROLLMENT)
(800) 968-6866
Entity
Organization
Contact information
Practice address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2349
(800) 968-6866
Mailing address
PO BOX 2388, GRAND RAPIDS, MI 49501-2388
(800) 968-6866
(616) 532-7230
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
MI
Other
Enumeration date
05/21/2014
Last updated
05/21/2014
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