Organization
GREAT LAKES MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD WAYNE MACAULEY MEDICAL DOCTOR (OWNER)
(517) 449-2452
Entity
Organization
Contact information
Practice address
1111 S MISSION ST, MOUNT PLEASANT, MI 48858-3944
(989) 773-9700
(989) 779-9701
Mailing address
611 COURT ST, PO BOX 428, WEST BRANCH, MI 48661-9390
(989) 773-9700
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
04411G
MI
Other
Enumeration date
01/25/2013
Last updated
12/27/2013
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