# INTERNAL MEDICINE OF NORTHERN MICHIGAN PLLC

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

## Provider details

- **NPI number:** 1467420901
- **Authorized official:** MR. ROBERT E FARRELL (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (231) 487-2460

## Contact information

- **Practice address:** 560 W MITCHELL ST, SUITE 300, PETOSKEY, MI 49770-2275
- **Practice address phone:** (231) 487-2460
- **Practice address fax:** (231) 487-6596
- **Mailing address:** 560 W MITCHELL ST, SUITE 300, PETOSKEY, MI 49770-2275
- **Mailing address phone:** (231) 487-2460
- **Mailing address fax:** (231) 487-6596

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/10/2006
- **Last updated:** 08/17/2011