Healthcare Provider Details

I. General information

NPI: 1164410841
Provider Name (Legal Business Name): MYMICHIGAN MEDICAL CENTER TAWAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 09/02/2025
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 MAPLE ST SUITE 202
TAWAS CITY MI
48763-9352
US

IV. Provider business mailing address

PO BOX 779
TAWAS CITY MI
48764-0779
US

V. Phone/Fax

Practice location:
  • Phone: 989-362-6108
  • Fax: 989-362-0161
Mailing address:
  • Phone: 989-362-6108
  • Fax: 989-362-0161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMANDA PEIRCE
Title or Position: MANAGER PATIENT ACCOUNTING
Credential:
Phone: 989-356-7597