# NORTHERN MICHIGAN ENDOCRINE PLLC

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

## Provider details

- **NPI number:** 1629484290
- **Authorized official:** DR. BASHAR KIAMI,MD MD (OWNER)
- **Authorized official phone:** (989) 745-6601

## Contact information

- **Practice address:** 1200 WEST NORTH DOWN RIVER RD, SUITE B, GRAYLING, MI 49738
- **Practice address phone:** (989) 745-6601
- **Practice address fax:** (989) 745-6605
- **Mailing address:** 1200 WEST NORTH DOWN RIVER RD, SUITE B, GRAYLING, MI 49738
- **Mailing address phone:** (989) 745-6601
- **Mailing address fax:** (989) 745-6605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 4301063746 | MI | Yes |

## Other

- **Enumeration date:** 07/03/2014
- **Last updated:** 09/10/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4174554 | — | MI |