Healthcare Provider Details

I. General information

NPI: 1407938590
Provider Name (Legal Business Name): MYMICHIGAN MEDICAL CENTER ALMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8776 E HOWARD CITY EDMORE RD
VESTABURG MI
48891-9406
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-0001
US

V. Phone/Fax

Practice location:
  • Phone: 989-268-3071
  • Fax: 989-268-9632
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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