Organization
NORTHERN ANESTHESIA PROVIDERS PC
Active
Organization
NORTHERN ANESTHESIA PROVIDERS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYTCH VANDERLOOVEN (OFFICE MANAGER)
(231) 348-2795
Entity
Organization
Contact information
Practice address
602 JACKSON ST, PETOSKEY, MI 49770-2220
(231) 348-2795
(231) 348-2031
Mailing address
602 JACKSON ST, PETOSKEY, MI 49770-2220
(231) 348-2795
(231) 348-2031
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B46025
BLUE CROSS BLUE SHIELD
—
Enumeration date
10/12/2006
Last updated
07/11/2025
Update your record
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