Healthcare Provider Details

I. General information

NPI: 1386213908
Provider Name (Legal Business Name): MCLAREN HEALTH MANAGEMENT GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2021
Last Update Date: 11/18/2022
Certification Date: 11/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 S STATE RD
DAVISON MI
48423-1721
US

IV. Provider business mailing address

1515 CAL DR
DAVISON MI
48423-9016
US

V. Phone/Fax

Practice location:
  • Phone: 810-214-1763
  • Fax: 810-600-7724
Mailing address:
  • Phone: 810-496-8713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVEN DALE LOY
Title or Position: CFO/VICE PRESIDENT
Credential:
Phone: 810-496-8633