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Organization
MICHIGAN INDEPENDENT PHYSICIANS ASSOCIATION, PLC
Active
Organization
MICHIGAN INDEPENDENT PHYSICIANS ASSOCIATION, PLC
Active
Other names
Michigan IPA
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MAURICE BOUVIER MD (CEO)
(810) 610-7972
Entity
Organization
Contact information
Practice address
12821 S SAGINAW ST, D13, GRAND BLANC, MI 48439-2457
(810) 344-9213
(810) 953-2964
Mailing address
12821 S SAGINAW ST, D13, GRAND BLANC, MI 48439-2457
(810) 344-9213
(810) 953-2964
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207QA0505X
Adult Medicine Physician
—
NULL
207QA0505X
Adult Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
NULL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
NULL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
NULL
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
05/19/2016
Last updated
06/23/2016
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