MEDICARE: OSCODA VA OUTPATIENT CLINIC

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	261QP2300X	Primary Care Clinic/Center	4704165258	MI

General Provider Information

NPI Number	:	1336243740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSCODA VA OUTPATIENT CLINIC

Provider Business Mailing Address
First Line	:	5671 N SKEEL AVE
Second Line	:	SUITE 4
City	:	OSCODA
State	:	MI
Zip	:	48750-1535
Country	:	US
Telephone Number	:	989-747-0026
Fax Number	:	989-747-0029

Provider Business Practice Location Address
First Line	:	5671 N SKEEL AVE
Second Line	:	SUITE 4
City	:	OSCODA
State	:	MI
Zip	:	48750-1535
Country	:	US
Telephone Number	:	989-747-0026
Fax Number	:	989-747-0029

Authorized Official
Title or Position	:	CHIEF OF STAFF
Name	:	DR. ALAN PAWLOW
Credential	:	MD
Telephone Number	:	989-497-2500

Provider Enumeration Date	:	09/08/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

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Practice Location Address:

OSCODA VA CLINIC , 5671 N SKEEL AVE
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48750-1535

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1477535193 — DANIEL B AZABACHE MD
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1265470843 — SAGINAW VAMC
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5671 N SKEEL AVE , SUITE 4
OSCODA, MI
48750-1535

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1902821499 — KENNETH A KISH LMSW, LMFT
Practice Location Address:

5671 N SKEEL AVE STE 4
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48750-1535

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1437257623 — DR. FADI MERHI DDS
Practice Location Address:

5671 N SKEEL AVE
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48750-1535

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1548360662 — MRS. JENNIE MARIE MARYLIW FNP-C
Practice Location Address:

5671 N SKEEL AVE , SUITE 4
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48750-1535

Practice Phone: 989-747-0026
Practice Fax: 989-747-0029

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