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General NPI Number Information
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NPI Number | 1306206578
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Entity Type | Organization
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Legal Business Name | INDIGO HOSPITAL MEDICINE - ADRIAN PLC
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Dates
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Enumeration Date | 03/02/2016
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 818 RIVERSIDE AVE
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City | ADRIAN
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State | MI
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Zip | 49221-1446
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Country | US
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Telephone | 517-265-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 10850 E TRAVERSE HWY STE. 4400
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-1364
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Country | US
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Telephone | 231-346-6807
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REIMBURSEMENT
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Name | ANNE MCMORROW
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Credential |
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Telephone | 231-346-6807
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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