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Organization
MERCY PROFESSIONAL SERVICES
Active
Organization
MERCY PROFESSIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE RIEMER-MATUZAK (CHIEF EXECUTIVE OFFICER)
(989) 348-5461
Entity
Organization
Contact information
Practice address
1100 E MICHIGAN AVE, GRAYLING, MI 49738-1312
(989) 348-5461
Mailing address
PO BOX 646, GRAYLING, MI 49738-0646
(989) 348-1040
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
Other
Enumeration date
05/20/2006
Last updated
02/08/2008
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