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Organization

MCLAREN NORTHERN MICHIGAN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEVEN THOMPSON (VP/CFO)
(231) 487-4094
Entity
Organization

Contact information

Practice address
416 CONNABLE AVE, PETOSKEY, MI 49770-2212
(231) 487-7129
Mailing address
416 CONNABLE AVE, PETOSKEY, MI 49770-2212
(231) 487-7129

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0B41031
BCBS BILLING GROUP NUMBER
MI
Enumeration date
12/11/2006
Last updated
10/01/2020
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