Organization
WEST BRANCH PULMONARY CLINIC PC
Active
Other names
West Branch Pulmonary & Sleep Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VICKI LYNN HERRICK (INSURANCE BILLER)
(810) 564-9270
Entity
Organization
Contact information
Practice address
780 N GAVORD RD, STERLING, MI 48659-9703
(989) 654-2168
(989) 654-2825
Mailing address
780 N GAVORD RD, STERLING, MI 48659-9703
(989) 654-2168
(989) 654-2825
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
TM0009037
MI
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007603
MCLAREN HEALTH PLAN
MI
01
—
110216075
RR MEDICARE
MI
01
—
115651012
BLUE CROSS BLUE SHIELD M
MI
01
—
122278
PREFERRED CHOICE PPO
MI
01
—
1679561443
NPI
MI
05
—
4261168
—
MI
01
—
4509887
AETNA
MI
01
—
54 0 F5 10350
BLUE CROSS BLUE SHIELD DM
MI
Enumeration date
08/30/2006
Last updated
01/05/2012
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