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General NPI Number Information
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NPI Number | 1801364005
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Entity Type | Organization
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Legal Business Name | NORTHERN FAMILY MEDICINE, PLLC
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Dates
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Enumeration Date | 11/06/2018
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 3890 CHARLEVOIX RD STE 230
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City | PETOSKEY
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State | MI
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Zip | 49770-8420
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Country | US
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Telephone | 123-134-7190
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Fax |
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Provider Business Mailing Address
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Address Line | 2810 CHARLEVOIX RD STE 104
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City | PETOSKEY
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State | MI
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Zip | 49770-8421
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Country | US
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Telephone | 231-347-1900
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JANET TALMO
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Credential | M D
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Telephone | 231-347-1900
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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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