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THUNDER BAY CLINIC MANAGEMENT INC NPI 1790746964


NPI Information

NPI: 1790746964
Provider Name: THUNDER BAY CLINIC MANAGEMENT INC
Classification: Urology - 208800000X
Entity Type: Organization
Address:
1065 US 23 NORTH
ALPENA, MI
ZIP 49707
Phone: (989) 354-0607
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THUNDER BAY CLINIC MANAGEMENT INC is an urology in Alpena, MI. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. THUNDER BAY CLINIC MANAGEMENT INC NPI is 1790746964. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1065 US 23 NORTH
ALPENA, MI
ZIP 49707
Phone: (989) 354-0607
Fax: (989) 356-6710

The provider's authorized official is Jane E Hardies .
The authorized official title is Office Manager and has the following contact phone number (989) 354-0607.

The enumeration date for this NPI number is 3/29/2006 and was last updated on 6/25/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208800000XUrologyBB012930MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13438729MEDICAIDMICHIGAN
2G16756MEDICARE UPIN
30M17350MEDICARE PINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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