Organization
BLUE WATER ONCOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH SCHEFFLER (OFFICE MANAGER)
(810) 985-1670
Entity
Organization
Contact information
Practice address
2605 ELECTRIC AVE, PORT HURON, MI 48060-6590
(810) 985-1670
(810) 982-9180
Mailing address
2605 ELECTRIC AVE, PORT HURON, MI 48060-6590
(810) 985-1670
(810) 982-9180
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
4301054609
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G41029
BCBS COMMON PROVIDER CODE
MI
01
—
CG7803
RAILROAD MEDICARE
MI
Enumeration date
11/01/2006
Last updated
08/22/2020
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