Organization
BLUE WATER MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCUS K. FREE M.D. (PRESIDENT/MEMBER)
(810) 479-4769
Entity
Organization
Contact information
Practice address
511 FORT ST, SUITE 102, PORT HURON, MI 48060-3922
(810) 479-4769
(888) 414-4545
Mailing address
511 FORT ST, SUITE 102, PORT HURON, MI 48060-3922
(810) 479-4769
(888) 414-4545
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4301093347
MI
Other
Enumeration date
05/25/2012
Last updated
05/25/2012
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