MEDICARE: MEDICAL ARTS CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	4301030939	MI
2	207RC0000X	Cardiovascular Disease Physician	4301037610	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023006822
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL ARTS CENTER

Provider Business Mailing Address
First Line	:	335 E HOUGHTON AVE
Second Line	:
City	:	WEST BRANCH
State	:	MI
Zip	:	48661-1127
Country	:	US
Telephone Number	:	989-345-0807
Fax Number	:	989-343-3107

Provider Business Practice Location Address
First Line	:	2463 S M 30
Second Line	:
City	:	WEST BRANCH
State	:	MI
Zip	:	48661-9312
Country	:	US
Telephone Number	:	989-345-0807
Fax Number	:	989-343-3107

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. ROBERT A I MCGRAIL
Credential	:
Telephone Number	:	989-343-3107

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	07/12/2010

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Directions to “MEDICAL ARTS CENTER ” Practice Location

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