Healthcare Provider Details

I. General information

NPI: 1538095419
Provider Name (Legal Business Name): GREAT LAKES BAY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4599 TOWNE CENTRE RD
SAGINAW MI
48604-2804
US

IV. Provider business mailing address

501 LAPEER AVE
SAGINAW MI
48607-1203
US

V. Phone/Fax

Practice location:
  • Phone: 989-759-6464
  • Fax:
Mailing address:
  • Phone: 989-759-6464
  • Fax: 989-399-8233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DAWN M CHRISTIAN
Title or Position: PROVIDER ENROLLMENT
Credential:
Phone: 989-759-6464