Organization Name: | MACKINAW CITY MEDICAL CENTER PC |
NPI Number: | 1558563981 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL HILARY FLOREK (PRESIDENT) |
Mailing Address: | 5208 Long Lake Rd Cheboygan |
State: | MI US |
Postal Code: | 497219159 |
Phone Number: | 2316252010 |
Fax Number: | |
NPI Enumeration Date: | 06/05/2007 |
NPI Last Update Date: | 09/05/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 5101013965 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |