Organization
MICHAEL J MOUTSATSON DO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAMES MOUTSATSON DO (MEMBER)
(989) 953-9777
Entity
Organization
Contact information
Practice address
2890 HEALTH PARKWAY, MOUNT PLEASANT, MI 48858-2961
(989) 953-9777
Mailing address
2890 HEALTH PARKWAY, MOUNT PLEASANT, MI 48858-2961
(989) 953-9777
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MM014511
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4775590
—
MI
01
—
5370114
BLUE CROSS BLUE SHIELD
MI
Enumeration date
11/27/2007
Last updated
10/03/2008
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