# GREAT LAKES MEDICAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942548946
- **Authorized official:** DR. RICHARD WAYNE MACAULEY MEDICAL DOCTOR (OWNER)
- **Authorized official phone:** (517) 449-2452

## Contact information

- **Practice address:** 1111 S MISSION ST, MOUNT PLEASANT, MI 48858-3944
- **Practice address phone:** (989) 773-9700
- **Practice address fax:** (989) 779-9701
- **Mailing address:** 611 COURT ST, PO BOX 428, WEST BRANCH, MI 48661-9390
- **Mailing address phone:** (989) 773-9700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 04411G | MI | Yes |

## Other

- **Enumeration date:** 01/25/2013
- **Last updated:** 12/27/2013