Organization
BROOKSIDE FAMILY MEDICINE A CENTER FOR HEALTH AND WELL-BEING PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA KAY GRAETZ MD (OWNER/PHYSICIAN)
(231) 922-0400
Entity
Organization
Contact information
Practice address
647 E EIGHTH ST, TRAVERSE CITY, MI 49686-2630
(231) 922-0400
(855) 586-8399
Mailing address
647 E EIGHTH ST, TRAVERSE CITY, MI 49686-2630
(231) 922-0400
(855) 586-8399
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301068214
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0280363
BLUE CARE NETWORK
MI
01
—
0B810140
BCBS OF MI GROUP
MI
05
—
4102107
—
MI
Enumeration date
12/03/2007
Last updated
02/15/2024
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