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General NPI Number Information
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NPI Number | 1497868111
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Entity Type | Organization
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Legal Business Name | SUTTONS BAY MEDICAL CLINIC, PLC
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | 93B FOURTH ST
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City | SUTTONS BAY
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State | MI
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Zip | 49682-0397
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Country | US
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Telephone | 231-271-5990
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Fax | 231-271-5959
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Provider Business Mailing Address
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Address Line | 93B FOURTH ST PO BOX 397
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City | SUTTONS BAY
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State | MI
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Zip | 49682-0397
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Country | US
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Telephone | 231-271-5990
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Fax | 231-271-5959
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Authorized Official
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Title or Position | MEMBER
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Name | THOMAS G LAMMY
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Credential | MD
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Telephone | 231-271-5990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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