Organization
MID-MICHIGAN DISTRICT HEALTH DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LIZ MARI (JOHN) BRADDOCK RS MS (HEALTH OFFICER)
(989) 831-3640
Entity
Organization
Contact information
Practice address
615 N STATE ST, STE. 1, STANTON, MI 48888-9702
(989) 831-5237
(989) 831-3666
Mailing address
615 N STATE ST, STE. 2, STANTON, MI 48888-9702
(989) 831-5237
(989) 831-5522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1464384
FACILITY/GROUP PROVIDER ID
MI
05
—
5100715
—
MI
Enumeration date
09/13/2005
Last updated
07/26/2021
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