Healthcare Provider Details

I. General information

NPI: 1447510425
Provider Name (Legal Business Name): COVENANT MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1447 N HARRISON
SAGINAW MI
48602
US

IV. Provider business mailing address

1447 N. HARRISON
SAGINAW MI
48602
US

V. Phone/Fax

Practice location:
  • Phone: 989-583-6100
  • Fax: 989-583-0108
Mailing address:
  • Phone: 989-583-2833
  • Fax: 989-583-2811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARGARET MAINE
Title or Position: DIRECTOR
Credential:
Phone: 989-583-6100