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General NPI Number Information
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NPI Number | 1114066693
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Entity Type | Organization
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Legal Business Name | MCLAREN MEDICAL GROUP
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 02/12/2016
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Provider Practice Location Address
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Address Line | 1198 N BELSAY RD BUILDING 3
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City | BURTON
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State | MI
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Zip | 48509-1669
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Country | US
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Telephone | 810-743-5100
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Fax | 810-715-1807
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Provider Business Mailing Address
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Address Line | 401 S BALLENGER HWY
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City | FLINT
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State | MI
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Zip | 48532-3638
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Country | US
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Telephone | 810-342-1000
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Fax | 810-342-1590
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Authorized Official
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Title or Position | CEO
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Name | MR. WILLIAM HARDIMON
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Credential |
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Telephone | 810-342-1040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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