Organization
INDIGO SERVICES, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE E MCMORROW (DIR. REIMBURSEMENT)
(231) 346-6807
Entity
Organization
Contact information
Practice address
1105 6TH ST, TRAVERSE CITY, MI 49684-2349
(231) 947-0673
(801) 740-2847
Mailing address
10850 E. TRAVERSE HWY., STE. 4400, TRAVERSE CITY, MI 49684-1320
(231) 346-6800
(231) 346-6052
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110B810320
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/02/2005
Last updated
12/22/2014
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