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NPI Code Detail

MEDICARE: MONTROSE FAMILY MEDICINE ASSOCIATES PC

MEDICARE: MONTROSE FAMILY MEDICINE ASSOCIATES PC
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
1207QA0000XAdolescent Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1396889242
Entity Type Code : Organization
Provider Name (Legal Business Name) : MONTROSE FAMILY MEDICINE ASSOCIATES PC
Provider Business Mailing Address
First Line : 190 E STATE ST
Second Line :
City : MONTROSE
State : MI
Zip : 48457-9144
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 190 E STATE ST
Second Line :
City : MONTROSE
State : MI
Zip : 48457-9144
Country : US
Telephone Number : 810-639-2056
Fax Number :
Authorized Official
Title or Position : OFFICE ASSISTANT
Name : CATHY HITCHCOCK
Credential :
Telephone Number : 810-639-2056
Provider Enumeration Date : 02/16/2007
Last Update Date : 08/22/2020

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