Organization
CENTRAL MICHIGAN UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL B SIMMONS M.D. (MANAGER)
(989) 953-4002
Entity
Organization
Contact information
Practice address
2981 HEALTH PKWY, SUITE A, MOUNT PLEASANT, MI 48858-9347
(989) 953-4002
(989) 953-7143
Mailing address
2981 HEALTH PKWY, SUITE A, MOUNT PLEASANT, MI 48858-9347
(989) 953-4002
(989) 953-7143
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301028129
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C71067
BCBS OF MICHIGAN
—
05
—
104574378
—
MI
Enumeration date
06/13/2013
Last updated
06/13/2013
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