| Organization Name: | NORTHERN LIGHTS FAMILY MEDICINE P. C. |
| NPI Number: | 1528207560 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL R. SCHAUB (PRESIDENT) |
| Mailing Address: | 9883 Us 31 Montague |
| State: | MI US |
| Postal Code: | 494379501 |
| Phone Number: | 2318936363 |
| Fax Number: | |
| NPI Enumeration Date: | 02/16/2009 |
| NPI Last Update Date: | 02/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 4301049583 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |