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Organization

MUNSON MEDICAL CENTER

Active
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Organization

MUNSON MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHLEEN LARAIA (VP ANCILLARY SERVICES)
(231) 392-8410
Entity
Organization

Contact information

Practice address
2513 MOMENTUM PL, CHICAGO, IL 60689-5325
(231) 935-8031
(231) 935-6081
Mailing address
2513 MOMENTUM PL, CHICAGO, IL 60689-5325
(231) 935-8031
(231) 935-6081

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
MI
363A00000X
Physician Assistant
5601002557
MI
363A00000X
Physician Assistant
5601004425
MI
363A00000X
Physician Assistant
5601005943
MI
363A00000X
Physician Assistant
5601006097
MI
363LA2100X
Acute Care Nurse Practitioner
4704212770
MI
363LA2100X
Acute Care Nurse Practitioner
4704253480
MI
363LA2100X
Acute Care Nurse Practitioner
4704299582
MI

Other

Enumeration date
08/14/2014
Last updated
04/01/2024
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