Organization
MUNSON HEALTHCARE MANISTEE
Active
Other names
West Shore Medical Center Physician Services
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN O SMITH (PRESIDENT AMBULATORY CLINICS)
(231) 935-5000
Entity
Organization
Contact information
Practice address
1293 E PARKDALE AVE, MANISTEE, MI 49660-8904
(231) 398-1750
(231) 398-1751
Mailing address
315 OAKGROVE ST, MANISTEE, MI 49660-1176
(231) 398-9266
(231) 398-9268
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
MI
207VG0400X
Gynecology Physician
—
MI
207X00000X
Orthopaedic Surgery Physician
—
MI
208000000X
Pediatrics Physician
—
MI
208600000X
Surgery Physician
Primary
—
MI
Other
Enumeration date
05/12/2011
Last updated
09/22/2022
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