Organization
LITTLE TRAVERSE PSYCHIATRIC ASSOCIATES, PC
Active
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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