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Organization

GERIATRIC PHYSICIAN STAFFING PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PHILLIP W SIEMER MD (PHYSICIAN)
(231) 271-5990
Entity
Organization

Contact information

Practice address
124 W FOURTH ST, SUTTONS BAY, MI 49682-9733
(231) 271-1200
(231) 271-5959
Mailing address
2700 N SETTERBO RD, SUTTONS BAY, MI 49682-9391
(231) 271-5990
(231) 271-5959

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301051573
MI
314000000X
Skilled Nursing Facility
Primary
4301051573
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1588612972
MI
Enumeration date
07/19/2012
Last updated
07/19/2012
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