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Organization

MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL

Active
Other names
Munson Healthcare OMH Medical Group-Lewiston RHC, OMH Medical Group Lewiston RHC
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL FRYE MD (PRES AMBULATORY & BUS DEVELOPMENT)
(704) 458-8010
Entity
Organization

Contact information

Practice address
3040 BOURN ST, LEWISTON, MI 49756
(989) 786-4877
(989) 786-2187
Mailing address
829 N CENTER AVE, GAYLORD, MI 49735-1595
(989) 731-2100
(989) 731-7929

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
261QR1300X
Rural Health Clinic/Center
Primary
282NR1301X
Rural Acute Care Hospital
238620
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
238620
CMS CERTIFICATION NUMBER
Enumeration date
08/31/2009
Last updated
04/17/2026
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