Organization
MCLAREN PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE C JACKS PORTER (VP/CFO)
(989) 894-3838
Entity
Organization
Contact information
Practice address
1807 M-55, WEST BRANCH, MI 48661-0000
(989) 345-0945
(989) 345-2831
Mailing address
1900 COLUMBUS AVE, ATTN: MCLAREN BAY REGION CEO, BAY CITY, MI 48708-6831
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301062477
MI
363A00000X
Physician Assistant
Primary
5601005840
MI
363LF0000X
Family Nurse Practitioner
4704214196
MI
Other
Enumeration date
04/29/2011
Last updated
05/22/2019
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