Organization
SEMINOLE SHORES INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL ANTHONY OGAS M.D. (OWNER)
(231) 739-2192
Entity
Organization
Contact information
Practice address
433 SEMINOLE RD, SUITE 105, MUSKEGON, MI 49444-3743
(231) 739-2192
(231) 739-2343
Mailing address
433 SEMINOLE RD, SUITE 105, MUSKEGON, MI 49444-3743
(231) 739-2192
(231) 739-2343
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
4301062711
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106110251
BLUE CROSS BLUE SHIELD
MI
05
—
4559980
—
MI
Enumeration date
11/02/2007
Last updated
07/01/2008
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