Organization
MUNSON MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN LARAIA (VP ANCILLARY SERVICES)
(231) 392-8410
Entity
Organization
Contact information
Practice address
2513 MOMENTUM PL, CHICAGO, IL 60689-5325
(231) 935-8031
(231) 935-6081
Mailing address
2513 MOMENTUM PL, CHICAGO, IL 60689-5325
(231) 935-8031
(231) 935-6081
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
MI
363A00000X
Physician Assistant
5601002557
MI
363A00000X
Physician Assistant
5601004425
MI
363A00000X
Physician Assistant
5601005943
MI
363A00000X
Physician Assistant
5601006097
MI
363LA2100X
Acute Care Nurse Practitioner
4704212770
MI
363LA2100X
Acute Care Nurse Practitioner
4704253480
MI
363LA2100X
Acute Care Nurse Practitioner
4704299582
MI
Other
Enumeration date
08/14/2014
Last updated
04/01/2024
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