# GERIATRIC PHYSICIAN STAFFING PC

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

## Provider details

- **NPI number:** 1558616144
- **Authorized official:** DR. PHILLIP W SIEMER MD (PHYSICIAN)
- **Authorized official phone:** (231) 271-5990

## Contact information

- **Practice address:** 124 W FOURTH ST, SUTTONS BAY, MI 49682-9733
- **Practice address phone:** (231) 271-1200
- **Practice address fax:** (231) 271-5959
- **Mailing address:** 2700 N SETTERBO RD, SUTTONS BAY, MI 49682-9391
- **Mailing address phone:** (231) 271-5990
- **Mailing address fax:** (231) 271-5959

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 4301051573 | MI | — |
| 314000000X | Skilled Nursing Facility | 4301051573 | MI | Yes |

## Other

- **Enumeration date:** 07/19/2012
- **Last updated:** 07/19/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1588612972 | — | MI |