{
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"IsOrgSubpart": "N",
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"OrgName": "MIDMICHIGAN CARDIOLOGY, PC",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "111 E WACKERLY ST",
"SecondLineMailingAddress": "SUITE D",
"MailingAddressCityName": "MIDLAND",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48642-7043",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "989-832-0100",
"MailingAddressFaxNumber": "989-923-1055",
"FirstLinePracticeLocationAddress": "609 QUARTER ST",
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"PracticeLocationAddressCityName": "GLADWIN",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48624-1941",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "989-246-6461",
"PracticeLocationAddressFaxNumber": "989-246-9467",
"EnumerationDate": "10/23/2007",
"LastUpdateDate": "10/23/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOODRUFF",
"AuthorizedOfficialFirstName": "NATHANIEL",
"AuthorizedOfficialMiddleName": "ROHDE",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "M.D., PH.D.",
"AuthorizedOfficialTelephoneNumber": "989-832-0100",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "174400000X",
"TaxonomyName": "Specialist",
"LicenseNumber": "NW065098",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}