Healthcare Provider Details

I. General information

NPI: 1467070508
Provider Name (Legal Business Name): MICHIGAN HEALTH CLINICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 03/29/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 FORTUNE BLVD
SAGINAW MI
48603-2287
US

IV. Provider business mailing address

3925 FORTUNE BLVD
SAGINAW MI
48603-2287
US

V. Phone/Fax

Practice location:
  • Phone: 989-341-5078
  • Fax: 989-499-7090
Mailing address:
  • Phone: 989-489-2300
  • Fax: 989-499-7090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID L. STOCKMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 989-341-5078