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Individual

DR. MARK MCKELVY GARNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
12935 S WEST BAY SHORE DR STE 260, TRAVERSE CITY, MI 49684-5597
(231) 642-1641
Mailing address
12935 S WEST BAY SHORE DR STE 260, TRAVERSE CITY, MI 49684-5597
(231) 642-1641

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301006596
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
68-0-B8-4791
BLUE CROSS BLUE SHIELD
MI
01
M025581
CHAMPUSTRICARE
MI
Enumeration date
11/29/2006
Last updated
01/11/2021
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