Organization
ST MARYS OF MICHIGAN SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L LONG VP (VICE PRESIDENT)
(989) 907-3095
Entity
Organization
Contact information
Practice address
4690 MCLEOD DR E, SAGINAW, MI 48604-2836
(989) 249-5454
(989) 249-5468
Mailing address
4690 MCLEOD DR E, SAGINAW, MI 48604-2836
(989) 249-5454
(989) 249-5468
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4301073051
MI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4301087160
MI
2085R0204X
Vascular & Interventional Radiology Physician
4301072478
MI
208600000X
Surgery Physician
—
—
2086S0127X
Trauma Surgery Physician
—
—
Other
Enumeration date
01/23/2007
Last updated
12/23/2008
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