MEDICARE: MCLAREN HEALTH MANAGEMENT GROUP

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1659963346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCLAREN HEALTH MANAGEMENT GROUP

Provider Business Mailing Address
First Line	:	1515 CAL DR
Second Line	:
City	:	DAVISON
State	:	MI
Zip	:	48423-9016
Country	:	US
Telephone Number	:	800-862-3132
Fax Number	:

Provider Business Practice Location Address
First Line	:	1309 S MISSION ST
Second Line	:
City	:	MOUNT PLEASANT
State	:	MI
Zip	:	48858-4207
Country	:	US
Telephone Number	:	989-317-3883
Fax Number	:	810-600-7899

Authorized Official
Title or Position	:	CFO/VICE PRESIDENT
Name	:	STEVEN DALE LOY
Credential	:
Telephone Number	:	810-496-8633

Provider Enumeration Date	:	02/04/2021
Last Update Date	:	11/18/2022

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