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NPI 1063598845

NPI 1063598845 : MUNSON HEALTHCARE CHARLEVOIX HOSPITAL : CHARLEVOIX, MI

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General NPI Number Information
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    NPI Number           |    1063598845
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    Entity Type          |    Organization 
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    Legal Business Name  |    MUNSON HEALTHCARE CHARLEVOIX HOSPITAL 
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Dates
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    Enumeration Date     |    10/27/2006
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    Last Update Date     |    03/17/2016
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Provider Practice Location Address
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    Address Line         |    14734 PARK AVE 
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    City                 |    CHARLEVOIX
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    State                |    MI
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    Zip                  |    49720-1931
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    Country              |    US
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    Telephone            |    231-547-4024
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    Fax                  |    231-547-8088
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Provider Business Mailing Address
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    Address Line         |    14700 LAKE SHORE DR 
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    City                 |    CHARLEVOIX
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    State                |    MI
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    Zip                  |    49720-1931
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    Country              |    US
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    Telephone            |    231-547-4024
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    Fax                  |    231-547-8088
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Authorized Official
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    Title or Position    |    CHIEF OPERATIONS OFFICER
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    Name                 |     CHRISTINE  WILHELM 
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    Credential           |    
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    Telephone            |    231-547-4024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    
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    License Number State |    
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