Organization
U P OTOLARYNGOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A KLIM DO (PRESIDENT SECRETARY)
(906) 786-6047
Entity
Organization
Contact information
Practice address
2525 5TH AVENUE SOUTH, ESCANABA, MI 49829
(906) 786-6047
(906) 786-0660
Mailing address
2525 5TH AVENUE SOUTH, ESCANABA, MI 49829
(906) 786-6047
(906) 786-0660
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B11004
BCBS GROUP
MI
01
—
CG4010
RAILROAD MEDICARE GROUP
—
Enumeration date
04/18/2006
Last updated
03/03/2008
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