MEDICARE: MYMICHIGAN MEDICAL CENTER TAWAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician
2	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110C56009	OTHER	MI	BCBS -INTERNAL MED/PEDS

General Provider Information

NPI Number	:	1003996679
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYMICHIGAN MEDICAL CENTER TAWAS

Provider Business Mailing Address
First Line	:	4000 WELLNESS DR
Second Line	:
City	:	MIDLAND
State	:	MI
Zip	:	48670-2000
Country	:	US
Telephone Number	:	844-832-1956
Fax Number	:	989-633-5241

Provider Business Practice Location Address
First Line	:	200 HEMLOCK
Second Line	:
City	:	TAWAS CITY
State	:	MI
Zip	:	48763
Country	:	US
Telephone Number	:	989-362-6108
Fax Number	:	989-362-9925

Authorized Official
Title or Position	:	MANAGER PATIENT ACCOUNTING
Name	:	SARAH JAMES
Credential	:
Telephone Number	:	989-701-4734

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	01/14/2026

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Practice Location Address:

200 HEMLOCK
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Practice Location Address:

200 HEMLOCK ST
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1952399743 — MYMICHIGAN MEDICAL CENTER TAWAS
Practice Location Address:

700 GERMAN ST
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1477716165 — MYMICHIGAN MEDICAL CENTER TAWAS
Practice Location Address:

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1679561468 — MYMICHIGAN MEDICAL CENTER TAWAS
Practice Location Address:

25 M 55 E
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Directions to “MYMICHIGAN MEDICAL CENTER TAWAS ” Practice Location

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