MEDICARE: MUNSON MEDICAL CENTER

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	2080N0001X	Neonatal-Perinatal Medicine Physician
2	273R00000X	Psychiatric Hospital Unit

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CB9942	OTHER	MI	RAILROAD
2	700B860160	OTHER	MI	BLUE CROSS GROUP

General Provider Information

NPI Number	:	1659385334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUNSON MEDICAL CENTER

Provider Business Mailing Address
First Line	:	2513 MOMENTUM PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60689-5325
Country	:	US
Telephone Number	:	231-935-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4230 COPPER RIDGE DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7256
Country	:	US
Telephone Number	:	231-935-5000
Fax Number	:

Authorized Official
Title or Position	:	COO MUNSON PHYSICIAN NETWORK
Name	:	BONNIE KRUSZKA
Credential	:
Telephone Number	:	231-935-4995

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	10/13/2025

Similar Medicare Providers

1588529101 — AMY LOUISE COLOMBO
Practice Location Address:

4230 COPPER RIDGE DR BLDG E
TRAVERSE CITY, MI
49684-7256

Practice Phone: 231-935-6880
Practice Fax:

1689230476 — MS. MIRIAM WEISS BROWN M.D.
Practice Location Address:

4230 COPPER RIDGE DR
TRAVERSE CITY, MI
49684-7256

Practice Phone: 231-935-6380
Practice Fax:

1194837336 — DR. THOMAS ROBERT HARDING MD
Practice Location Address:

4230 COPPER RIDGE DR
TRAVERSE CITY, MI
49684-7256

Practice Phone: 231-935-6380
Practice Fax:

1972467363 — LAURA ELIZABETH POND DNP, PMHNP-BC
Practice Location Address:

4230 COPPER RIDGE DR BLDG E
TRAVERSE CITY, MI
49684-7256

Practice Phone: 231-935-6382
Practice Fax:

1386672665 — MUNSON MEDICAL CENTER
Practice Location Address:

4230 COPPER RIDGE DR
TRAVERSE CITY, MI
49684-7256

Practice Phone: 231-935-5000
Practice Fax:

1992803795 — ANDREA SYNNESTVEDT RUSSELL LMSW
Practice Location Address:

4230 COPPER RIDGE DR
TRAVERSE CITY, MI
49684-7256

Practice Phone: 231-935-6380
Practice Fax: 231-935-6920

Directions to “MUNSON MEDICAL CENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.