Organization
MEMORIAL HOSPITAL
Active
Parent organization
MEMORIAL HOSPITAL
Other names
Memorial Medical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEMORIAL HOSPITAL
Authorized official
JORRI M TREMAIN (CFO)
(989) 729-4466
Entity
Organization
Contact information
Practice address
826 W KING ST, OWOSSO, MI 48867-2120
(989) 723-5211
(989) 723-9446
Mailing address
113 E WILLIAMS ST, OWOSSO, MI 48867-2360
(989) 725-6528
(989) 723-9446
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
1060000059
MI
207RG0100X
Gastroenterology Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
1060000059
MI
207X00000X
Orthopaedic Surgery Physician
1060000059
MI
207YS0123X
Facial Plastic Surgery Physician
1060000059
MI
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
2084N0400X
Neurology Physician
1060000059
MI
208600000X
Surgery Physician
106000059
MI
208D00000X
General Practice Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080G810270
BLUE CROSS BLUE SHIELD
MI
05
—
1316008006
—
MI
Enumeration date
12/13/2006
Last updated
09/21/2022
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