MEDICARE: MYMICHIGAN MEDICAL CENTER GLADWIN

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	261QR1300X	Rural Health Clinic/Center		MI

General Provider Information

NPI Number	:	1558790162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYMICHIGAN MEDICAL CENTER GLADWIN

Provider Business Mailing Address
First Line	:	4000 WELLNESS DR
Second Line	:
City	:	MIDLAND
State	:	MI
Zip	:	48670-2000
Country	:	US
Telephone Number	:	844-832-1956
Fax Number	:	989-633-5241

Provider Business Practice Location Address
First Line	:	335 E HOUGHTON AVE
Second Line	:
City	:	WEST BRANCH
State	:	MI
Zip	:	48661-1127
Country	:	US
Telephone Number	:	989-345-8120
Fax Number	:

Authorized Official
Title or Position	:	MANAGER, PROVIDER ENROLLMENT
Name	:	SARAH JAMES
Credential	:
Telephone Number	:	989-701-4734

Provider Enumeration Date	:	11/04/2013
Last Update Date	:	01/15/2026

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