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Organization

MICHAEL T MCAULIFFE MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMY L BAHNSEN (SENIOR CREDENTIALING COORDINATOR)
(419) 824-7334
Entity
Organization

Contact information

Practice address
818 RIVERSIDE AVE, ADRIAN, MI 49221-1446
(517) 265-0429
(517) 265-0236
Mailing address
5855 MONROE ST, ATTN: AMY BAHNSEN, SYLVANIA, OH 43560-2269
(419) 824-7334
(419) 824-7359

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0285838
OH
Enumeration date
09/02/2010
Last updated
09/02/2010
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