MEDICARE: FOREST AREA MEDICAL CENTERS 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
1	363A00000X	Physician Assistant	5601002665	MI

General Provider Information

NPI Number	:	1639277791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREST AREA MEDICAL CENTERS PC

Provider Business Mailing Address
First Line	:	113 MAIN STREET
Second Line	:	P.O. BOX 30
City	:	FIFE LAKE
State	:	MI
Zip	:	49633
Country	:	US
Telephone Number	:	231-879-4810
Fax Number	:	231-879-4916

Provider Business Practice Location Address
First Line	:	113 MAIN STREET
Second Line	:
City	:	FIFE LAKE
State	:	MI
Zip	:	49633
Country	:	US
Telephone Number	:	231-879-4810
Fax Number	:	231-879-4916

Authorized Official
Title or Position	:	OWNER
Name	:	MR. SCOTT MARTIN BROWN
Credential	:	PA-C
Telephone Number	:	231-879-4810

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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