Organization
FOUR SEASONS EMERGENCY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY ANN ANCEL DO (PRESIDENT)
(231) 876-7245
Entity
Organization
Contact information
Practice address
400 HOBART ST, CADILLAC, MI 49601-2331
(231) 876-7245
Mailing address
PO BOX 58, CADILLAC, MI 49601-0058
(866) 898-7139
(616) 975-9824
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700H310500
BCBS
—
Enumeration date
09/21/2006
Last updated
06/04/2008
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