Healthcare Provider Details

I. General information

NPI: 1669548061
Provider Name (Legal Business Name): MYMICHIGAN MEDICAL CENTER SAGINAW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 09/02/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 W SAGINAW RD
VASSAR MI
48768-9483
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-2000
US

V. Phone/Fax

Practice location:
  • Phone: 989-823-5020
  • Fax: 989-823-7881
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704173083
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301079750
License Number StateMI

VIII. Authorized Official

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