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Individual

DR. MICHAEL J PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
401 MUNSON AVE, TRAVERSE CITY, MI 49686
(231) 933-9150
(231) 933-1553
Mailing address
401 MUNSON AVE, TRAVERSE CITY, MI 49686-3041
(231) 933-9150
(231) 933-1553

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301056827
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1002803802
BCBS PROVIDER ID
MI
01
364465889
TAX ID
MI
01
P114353
BLUE CARE NETWORK ID
MI
Enumeration date
07/08/2005
Last updated
07/11/2018
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