Organization
HURON MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA LYNN STILES (OFFICE MANAGER/BILLER)
(810) 982-5200
Entity
Organization
Contact information
Practice address
1221 PINE GROVE AVE, PORT HURON, MI 48060-3511
(810) 982-5200
(810) 982-9776
Mailing address
1231 PINE GROVE AVE STE 2F, PORT HURON, MI 48060-3500
(810) 982-5200
(810) 982-9776
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
4301051703
MI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110G41039
BCBSM HANNA
MI
05
—
3165470
—
MI
05
—
4397059
—
MI
01
—
P115104
BCN HANNA
MI
01
—
P78652
BCN ALSAWAH
MI
Enumeration date
07/16/2006
Last updated
03/30/2026
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