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NORTHSHORE MEDICAL CLINIC P C NPI 1841357464


NPI Information

NPI: 1841357464
Provider Name: NORTHSHORE MEDICAL CLINIC P C
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
7786 MULLETT LAKE RD
CHEBOYGAN, MI
ZIP 49721
Phone: (231) 627-2869
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NORTHSHORE MEDICAL CLINIC P C is an obstetrics gynecology in Cheboygan, MI. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. NORTHSHORE MEDICAL CLINIC P C NPI is 1841357464. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7786 MULLETT LAKE RD
CHEBOYGAN, MI
ZIP 49721-056
Phone: (231) 627-2869
Fax: (231) 627-2869

The provider's authorized official is Jerome E Siudara .
The authorized official title is Physician and has the following contact phone number (231) 627-2869.

The enumeration date for this NPI number is 1/2/2007 and was last updated on 12/19/2008.


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
1207V00000XObstetrics & Gynecology5101005875MICHIGANYes

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
1111350021MEDICAIDMICHIGAN
2E26180MEDICARE UPIN
31651630495OTHERMICHIGANBS OF MI
45163049MEDICARE ID-TYPE UNSPECIFIED

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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