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General NPI Number Information
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NPI Number | 1790867216
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Entity Type | Organization
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Legal Business Name | MUNSON HEALTHCARE CHARLEVOIX HOSPITAL
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 223 N PARK ST
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City | BOYNE CITY
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State | MI
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Zip | 49712-1220
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Country | US
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Telephone | 231-582-5314
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Fax | 231-582-5338
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Provider Business Mailing Address
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Address Line | 223 N PARK ST
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City | BOYNE CITY
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State | MI
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Zip | 49712-1220
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Country | US
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Telephone | 231-582-5314
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Fax | 231-582-5338
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Authorized Official
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Title or Position | COO MUNSON PHYSICIAN NETWORK
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Name | BONNIE KRUSZKA
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Credential |
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Telephone | 231-935-4995
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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 | MI
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