Organization Name: | PINE RIVER MEDICAL ASSOCIATES, P.C. |
NPI Number: | 1538102694 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAMELA M NEWCOMB (HUMAN RESOURCE OFFICER) |
Mailing Address: | 14734 Park Ave Charlevoix |
State: | MI US |
Postal Code: | 49720 |
Phone Number: | 2315476554 |
Fax Number: | |
NPI Enumeration Date: | 06/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | DJ033990 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |