Individual
MARITES Q ANSAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
927 RIVERSIDE PLZ, IRON RIVER, MI 49935-1529
(906) 265-2165
Mailing address
1400 W ICE LAKE RD, IRON RIVER, MI 49935-9526
(906) 265-6121
(906) 265-4245
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301071277
MI
208000000X
Pediatrics Physician
4301071277
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34187400
EDS
—
05
—
3516870
—
MI
01
—
370013653
RR CARE
—
01
—
700C610000
BCBS
—
Enumeration date
06/15/2005
Last updated
09/09/2013
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