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Organization
MCLAREN NORTHERN MICHIGAN
Active
Organization
MCLAREN NORTHERN MICHIGAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN THOMPSON (VP/CFO)
(231) 487-4094
Entity
Organization
Contact information
Practice address
416 CONNABLE AVE, PETOSKEY, MI 49770-2212
(231) 487-7129
Mailing address
416 CONNABLE AVE, PETOSKEY, MI 49770-2212
(231) 487-7129
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B41031
BCBS BILLING GROUP NUMBER
MI
Enumeration date
12/11/2006
Last updated
10/01/2020
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