Organization
THUNDER BAY EMERGENCY PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVIN CLAYTON DO (HEAD OF THE GROUP)
(800) 968-6866
Entity
Organization
Contact information
Practice address
1501 W CHISHOLM ST, ALPENA, MI 49707-1401
(800) 968-6866
(616) 532-7230
Mailing address
PO BOX 2347, GRAND RAPIDS, MI 49501-2347
(800) 968-6866
(616) 532-7230
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5010009914
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI7552
RAILROAD MEDICARE GROUP
MI
Enumeration date
05/31/2005
Last updated
01/14/2008
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