Healthcare Provider Details

I. General information

NPI: 1902841414
Provider Name (Legal Business Name): MYMICHIGAN MEDICAL CENTER MIDLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 WELLNESS DR
MIDLAND MI
48670-0001
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-0001
US

V. Phone/Fax

Practice location:
  • Phone: 989-839-3000
  • Fax:
Mailing address:
  • Phone: 844-832-1956
  • Fax: 989-633-5241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number560020
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: SARAH JAMES
Title or Position: MANAGER, PROVIDER ENROLLMENT
Credential:
Phone: 989-701-4734