Healthcare Provider Details

I. General information

NPI: 1417045006
Provider Name (Legal Business Name): MYMICHIGAN MEDICAL CENTER ALMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 N ALGER RD SUITE G
ALMA MI
48801-1072
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-2000
US

V. Phone/Fax

Practice location:
  • Phone: 989-463-2966
  • Fax: 989-463-5255
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: AMANDA M PEIRCE
Title or Position: MANAGER PATIENT ACCOUNTS
Credential:
Phone: 989-356-7597