# NORTHERN PINES HEALTH CENTER, PC

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

## Provider details

- **NPI number:** 1578547071
- **Authorized official:** DR. MITZIE J HEWITT DO (OWNER)
- **Authorized official phone:** (231) 269-4185

## Contact information

- **Practice address:** 11293 N M 37, SUITE A, BUCKLEY, MI 49620-9593
- **Practice address phone:** (231) 269-4185
- **Practice address fax:** (231) 269-4461
- **Mailing address:** 11293 N M 37, SUITE A, BUCKLEY, MI 49620-9593
- **Mailing address phone:** (231) 269-4185
- **Mailing address fax:** (231) 269-4461

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 305R00000X | Preferred Provider Organization | 5101013101 | MI | — |

## Other

- **Enumeration date:** 11/30/2005
- **Last updated:** 03/24/2021