MEDICARE: MSN HEALTHCARE

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	261QH0100X	Health Service Clinic/Center	5101013724	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0155810705	OTHER	MI	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1760660401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MSN HEALTHCARE

Provider Business Mailing Address
First Line	:	1715 W DEAN RD STE B
Second Line	:
City	:	TEMPERANCE
State	:	MI
Zip	:	48182-9406
Country	:	US
Telephone Number	:	734-847-4700
Fax Number	:	734-847-4711

Provider Business Practice Location Address
First Line	:	1715 W DEAN RD STE B
Second Line	:
City	:	TEMPERANCE
State	:	MI
Zip	:	48182-9406
Country	:	US
Telephone Number	:	734-847-4700
Fax Number	:	734-847-4711

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARK STEPHEN NEUMANN
Credential	:	D.O.
Telephone Number	:	734-847-4700

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	05/21/2008

Similar Medicare Providers

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Practice Location Address:

1715 W DEAN RD , SUITE C
TEMPERANCE, MI
48182-9406

Practice Phone: 734-847-8100
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1073718607 — MOTHER'S OWN BIRTH AND WOMEN'S CENTER, LLC
Practice Location Address:

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1588869820 — MRS. MARY ANN DURBIN CNM
Practice Location Address:

1715 W DEAN RD , SUITE C
TEMPERANCE, MI
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1558185686 — MS. HANNAH GABRIELLE SALK PA
Practice Location Address:

8765 LEWIS AVE
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Practice Location Address:

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1134125024 — PAMELA J HACKL DO
Practice Location Address:

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Directions to “MSN HEALTHCARE ” Practice Location

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