# DICKINSON COUNTY HEALTHCARE SYSTEM

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Dickinson Medical Services at Bayside Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821345646
- **Authorized official:** ALICIA HENDERSON (PHYSICIAN BILLING SUPERVISOR)
- **Authorized official phone:** (906) 776-5665

## Contact information

- **Practice address:** 2001 MINNEAPOLIS AVE, SUITE E, GLADSTONE, MI 49837-2060
- **Practice address phone:** (906) 428-2000
- **Mailing address:** PO BOX 549, IRON MOUNTAIN, MI 49801-0549
- **Mailing address phone:** (906) 774-1313
- **Mailing address fax:** (906) 776-5639

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/10/2012
- **Last updated:** 08/24/2012