Organization
ELK RAPIDS MEDICAL CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANN K KUENKER D.O. (PRESIDENT/OWNER)
(231) 264-0700
Entity
Organization
Contact information
Practice address
516 BRIDGE ST, POST OFFICE BOX 119, ELK RAPIDS, MI 49629-9701
(231) 264-0700
Mailing address
516 BRIDGE ST, ELK RAPIDS, MI 49629-9701
(231) 264-0700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AK1664069
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0850500144
BCBS PROVIDER NUMBER
MI
05
—
4165027
—
MI
Enumeration date
11/28/2007
Last updated
11/28/2007
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