Healthcare Provider Details

I. General information

NPI: 1184941536
Provider Name (Legal Business Name): MERCY HEALTH PARTNERS OBSTETRICS AND GYNECOLOGY SPECIALIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 04/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1778 SANFORD ST
MUSKEGON MI
49441-2537
US

IV. Provider business mailing address

PO BOX 1847
MUSKEGON MI
49443-1847
US

V. Phone/Fax

Practice location:
  • Phone: 231-727-4444
  • Fax: 231-727-4451
Mailing address:
  • Phone: 231-727-4444
  • Fax: 231-727-4451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE LOHMAN
Title or Position: DIRECTOR NETWORK FINANCIAL SERVICES
Credential:
Phone: 231-727-4499