MEDICARE: MARY D HUNT D.O.

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	5101010433	MI

General Provider Information

NPI Number	:	1528154432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY D HUNT D.O.

Provider Business Mailing Address
First Line	:	221 W LAKE LANSING RD
Second Line	:	SUITE 300
City	:	EAST LANSING
State	:	MI
Zip	:	48823-8661
Country	:	US
Telephone Number	:	517-332-3980
Fax Number	:	517-332-3983

Provider Business Practice Location Address
First Line	:	221 W LAKE LANSING RD
Second Line	:	SUITE 300
City	:	EAST LANSING
State	:	MI
Zip	:	48823-8661
Country	:	US
Telephone Number	:	517-332-3980
Fax Number	:	517-332-3983

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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