Organization
LITTLE TRAVERSE PSYCHIATRIC ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT GEORGE FAWCETT M.D. (PRESIDENT)
(231) 487-2415
Entity
Organization
Contact information
Practice address
2206 MITCHELL PARK DR, STE 10, PETOSKEY, MI 49770-8674
(231) 487-2415
(231) 487-6569
Mailing address
2206 MITCHELL PARK DR, STE 10, PETOSKEY, MI 49770-8674
(231) 487-2415
(231) 487-6569
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260B41060
BLUE CROSS
MI
Enumeration date
01/17/2007
Last updated
05/13/2013
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