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General NPI Number Information
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NPI Number | 1780035410
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Entity Type | Organization
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Legal Business Name | PINNACLE HEALTH SYSTEM
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Dates
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Enumeration Date | 06/23/2016
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Last Update Date | 06/23/2016
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Provider Practice Location Address
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Address Line | 205 S FRONT ST BRADY BUILDING GME OFFICE BRADY 9
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City | HARRISBURG
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State | PA
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Zip | 17104-1619
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Country | US
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Telephone | 717-231-8724
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Fax |
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Provider Business Mailing Address
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Address Line | 12720 34 MILE RD
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City | BRUCE TWP
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State | MI
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Zip | 48065-3220
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Country | US
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Telephone | 586-381-8121
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Fax |
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Authorized Official
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Title or Position | INTERNAL MEDICINE RESIDENT
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Name | DR. MIGUEL ANGEL HERRERA-MARTINEZ
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Credential | M.D.
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Telephone | 586-381-8121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MT211930
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | MT211930
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License Number State | PA
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