Healthcare Provider Details
I. General information
NPI: 1164467916
Provider Name (Legal Business Name): PINCONNING MEDICAL CENTER P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2006
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4175 N EUCLID AVE STE 3
BAY CITY MI
48706-2483
US
IV. Provider business mailing address
712 S TRUMBULL ST
BAY CITY MI
48708-4211
US
V. Phone/Fax
- Phone: 899-684-8183
- Fax: 989-684-8203
- Phone: 899-684-8186
- Fax: 989-684-8203
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
WILLIAM
E
BERNER
Title or Position: CLINIC ADMINISTRATOR
Credential:
Phone: 989-892-7722