Individual
DR. MARYBETH HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
500 CAMPUS DR, HANCOCK, MI 49930-1569
(906) 483-1000
(906) 483-1103
Mailing address
500 CAMPUS DR, HANCOCK, MI 49930-1569
(906) 483-1000
(906) 483-1103
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MI51010262
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0829560001
MEDICARE DME
MI
01
—
0C16002
MEDICARE GROUP
MI
05
—
114509440
—
MI
01
—
MH010262
BLUECROSS STATE ID
MI
Enumeration date
05/08/2006
Last updated
12/07/2009
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