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General NPI Number Information
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NPI Number | 1245916709
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Entity Type | Organization
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Legal Business Name | ACV TRAVERSE CITY PLLC
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 01/18/2026
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Provider Practice Location Address
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Address Line | 3865 W FRONT ST STE 4-5
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-8101
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Country | US
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Telephone | 231-252-0414
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Fax | 231-252-0416
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Provider Business Mailing Address
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Address Line | 3865 W FRONT ST STE 4-5
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-8101
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Country | US
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Telephone | 231-252-0414
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Fax | 231-252-0416
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Authorized Official
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Title or Position | RCM DIRECTOR
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Name | SHAWNA MILLER
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Credential |
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Telephone | 616-226-5202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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