MEDICARE: NORTH WILTON HEALTH PLLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1053120022
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH WILTON HEALTH PLLC

Provider Business Mailing Address
First Line	:	4425 N AIRPORT RD
Second Line	:
City	:	SAINT JOHNS
State	:	MI
Zip	:	48879-9780
Country	:	US
Telephone Number	:	989-640-2788
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 S SCOTT RD
Second Line	:
City	:	SAINT JOHNS
State	:	MI
Zip	:	48879-8044
Country	:	US
Telephone Number	:	989-224-8936
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JACOB MICHAEL MONESTERSKY
Credential	:	DO
Telephone Number	:	989-640-2788

Provider Enumeration Date	:	01/04/2025
Last Update Date	:	01/04/2025

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Directions to “NORTH WILTON HEALTH PLLC ” Practice Location

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