Organization
FAMILY PRACTICE OF CADILLAC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL CORWIN (OFFICE MANAGER)
(231) 775-9741
Entity
Organization
Contact information
Practice address
827 E DIVISION ST, CADILLAC, MI 49601-2015
(231) 775-9741
Mailing address
827 E DIVISION ST, CADILLAC, MI 49601-2015
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080H36303
BLUE CROSS BLUE SHIELD ID
MI
01
—
CA0610
RAILROAD MEDICARE
MI
Enumeration date
08/31/2006
Last updated
11/02/2020
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