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Organization

PETOSKEY SURGEONS, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEVIN M. MARKHAM M.D. (PRESIDENT)
(231) 487-1900
Entity
Organization

Contact information

Practice address
521 MONROE ST, PETOSKEY, MI 49770-2266
(231) 487-1900
(231) 348-0984
Mailing address
521 MONROE ST, PETOSKEY, MI 49770-2266
(231) 487-1900
(231) 348-0984

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2086S0129X
Vascular Surgery Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020B41012
BLUE CARE NETWORK
MI
Enumeration date
04/21/2006
Last updated
06/07/2012
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