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Organization

MUNSON MEDICAL CENTER

Active
Other names
Michelin Group
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ELLEN O SMITH (PRESIDENT AMBULATORY CLINICS)
(231) 935-7450
Entity
Organization

Contact information

Practice address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-5000
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-5000

Taxonomy

Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
363LX0001X
Obstetrics & Gynecology Nurse Practitioner

Other

Enumeration date
08/09/2010
Last updated
09/22/2022
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