MEDICARE: PINCONNING MEDICAL CENTER P.C.

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
2	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1083930663	OTHER	MI	NPI
2	080Z910290	OTHER	MI	BCBS
3	1012455	OTHER	MI	MCLAREN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	010Z900580	OTHER	MI	BCBS GROUP
6	0Z90058	OTHER	MI	BCBS GROUP
7	0Z90055	OTHER	MI	BCBS PA GROUP

General Provider Information

NPI Number	:	1639116494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINCONNING MEDICAL CENTER P.C.

Provider Business Mailing Address
First Line	:	712 S TRUMBULL ST
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-4211
Country	:	US
Telephone Number	:	899-684-8183
Fax Number	:	899-684-8203

Provider Business Practice Location Address
First Line	:	204 W 3RD ST
Second Line	:
City	:	PINCONNING
State	:	MI
Zip	:	48650-9622
Country	:	US
Telephone Number	:	989-879-3771
Fax Number	:	989-879-3788

Authorized Official
Title or Position	:	CLINIC ADMINISTRATOR
Name	:	MR. WILLIAM E BERNER
Credential	:
Telephone Number	:	989-892-7722

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	06/29/2021

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Directions to “PINCONNING MEDICAL CENTER P.C. ” Practice Location

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