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Organization

MCLAREN BAY REGION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIELLE C JACKS PORTER (CFO)
(989) 894-3838
Entity
Organization

Contact information

Practice address
1900 COLUMBUS AVE, BAY CITY, MI 48708
(989) 894-3000
Mailing address
1900 COLUMBUS AVE, BAY CITY, MI 48708-6831
(989) 894-3000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207RC0000X
Cardiovascular Disease Physician
207RC0001X
Clinical Cardiac Electrophysiology Physician
207RI0011X
Interventional Cardiology Physician
207T00000X
Neurological Surgery Physician
208000000X
Pediatrics Physician
2084N0400X
Neurology Physician
2086S0129X
Vascular Surgery Physician
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
363A00000X
Physician Assistant
363AS0400X
Surgical Physician Assistant
363L00000X
Nurse Practitioner
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
03/15/2012
Last updated
08/07/2018
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