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NPI Code Detail

MEDICARE: MCLAREN PRIMARY CARE

MEDICARE: MCLAREN PRIMARY CARE
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1861415796
Entity Type Code : Organization
Provider Name (Legal Business Name) : MCLAREN PRIMARY CARE
Provider Business Mailing Address
First Line : 1900 COLUMBUS AVE
Second Line : ATTN: MCLAREN BAY REGION CEO
City : BAY CITY
State : MI
Zip : 48708-6831
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 337 E HOUGHTON AVE
Second Line :
City : WEST BRANCH
State : MI
Zip : 48661-1127
Country : US
Telephone Number : 989-345-5240
Fax Number : 989-345-4513
Authorized Official
Title or Position : VP/CFO
Name : DANIELLE C JACKS PORTER
Credential :
Telephone Number : 989-894-3838
Provider Enumeration Date : 07/25/2006
Last Update Date : 05/22/2019

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Directions to “MCLAREN PRIMARY CARE ” Practice Location

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