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Organization

LAKE HURON OB GYN PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NANCY BISCHER MACCHIARELLA D.O. (OWNER)
(989) 269-3923
Entity
Organization

Contact information

Practice address
1005 S VAN DYKE RD, BAD AXE, MI 48413-9614
(989) 269-3923
(989) 269-3983
Mailing address
1005 S VAN DYKE RD, BAD AXE, MI 48413-9614
(989) 269-3923
(989) 269-3983

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
NK013377
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1603210171
BLUE CROSS BLUE SHIELD MI
MI
01
1653210895
BLUE CROSS BLUE SHIELD MI
MI
05
4624157
MI
05
4645433
MI
Enumeration date
11/02/2006
Last updated
04/16/2021
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