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General NPI Number Information
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NPI Number | 1194981415
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Entity Type | Organization
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Legal Business Name | RICHARD P. PAYEA, M.D., PC
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Dates
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Enumeration Date | 08/06/2008
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Last Update Date | 08/06/2008
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Provider Practice Location Address
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Address Line | 1195 TAWAS BEACH RD
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City | EAST TAWAS
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State | MI
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Zip | 48730-9346
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Country | US
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Telephone | 989-362-2141
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Fax | 989-362-7740
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Provider Business Mailing Address
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Address Line | 1195 TAWAS BEACH RD
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City | EAST TAWAS
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State | MI
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Zip | 48730-9346
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Country | US
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Telephone | 989-362-2141
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Fax | 989-362-7740
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Authorized Official
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Title or Position | CEO
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Name | DR. RICHARD P PAYEA
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Credential | MD
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Telephone | 989-362-2141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301047848
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License Number State | MI
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