Healthcare Provider Details

I. General information

NPI: 1639116494
Provider Name (Legal Business Name): PINCONNING MEDICAL CENTER P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W 3RD ST
PINCONNING MI
48650-9622
US

IV. Provider business mailing address

712 S TRUMBULL ST
BAY CITY MI
48708-4211
US

V. Phone/Fax

Practice location:
  • Phone: 989-879-3771
  • Fax: 989-879-3788
Mailing address:
  • Phone: 899-684-8183
  • Fax: 899-684-8203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily 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