Organization Name: | MCLAREN MEDICAL MANAGEMENT, INC. |
NPI Number: | 1104294354 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM HARDIMON (CEO) |
Mailing Address: | 611 Court St West Branch |
State: | MI US |
Postal Code: | 486618820 |
Phone Number: | 9893457000 |
Fax Number: | 9893457479 |
NPI Enumeration Date: | 09/04/2015 |
NPI Last Update Date: | 09/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |