Organization
NORTHERN MICHIGAN ALLERGY & ASTHMA CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE MARIE LINEHAN (OFFICE MANAGER)
(231) 487-6575
Entity
Organization
Contact information
Practice address
405 N DIVISION RD, SUITE 4, PETOSKEY, MI 49770-9045
(231) 487-6575
(231) 439-9837
Mailing address
405 N DIVISION RD, SUITE 4, PETOSKEY, MI 49770-9045
(231) 487-6575
(231) 439-9837
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
AL052216
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030004444
RAILROAD MEDICARE
MI
01
—
0302464921
BLUE CROSS PIN
MI
05
—
4091246-10
—
MI
Enumeration date
05/07/2007
Last updated
07/13/2011
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