# MICHIGAN INDEPENDENT PHYSICIANS ASSOCIATION, PLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Michigan IPA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912354986
- **Authorized official:** ROBERT MAURICE BOUVIER MD (CEO)
- **Authorized official phone:** (810) 610-7972

## Contact information

- **Practice address:** 12821 S SAGINAW ST, D13, GRAND BLANC, MI 48439-2457
- **Practice address phone:** (810) 344-9213
- **Practice address fax:** (810) 953-2964
- **Mailing address:** 12821 S SAGINAW ST, D13, GRAND BLANC, MI 48439-2457
- **Mailing address phone:** (810) 344-9213
- **Mailing address fax:** (810) 953-2964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 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