Healthcare Provider Details

I. General information

NPI: 1841545209
Provider Name (Legal Business Name): HURLEY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2012
Last Update Date: 07/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HURLEY PLZ
FLINT MI
48503-5902
US

IV. Provider business mailing address

4202 CEDAR BEND DR
GRAND BLANC MI
48439-3410
US

V. Phone/Fax

Practice location:
  • Phone: 810-626-6426
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NW0100X
TaxonomyWomen's Hospital
License Number5101020080
License Number StateMI

VIII. Authorized Official

Name: JOHN HEBERT
Title or Position: OB/GYN PROGRAM DIRECTOR
Credential:
Phone: 810-262-6426