Healther Providers Data Logo


Provider Type Icon

GREAT LAKES HEALTHCARE PLLC NPI 1881855328


NPI Information

NPI: 1881855328
Provider Name: GREAT LAKES HEALTHCARE, PLLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
251 E PECK RD
PECK, MI
ZIP 48466
Phone: (810) 378-4900
Get Directions

GREAT LAKES HEALTHCARE, PLLC is a family medicine in Peck, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GREAT LAKES HEALTHCARE, PLLC NPI is 1881855328. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

251 E PECK RD
PECK, MI
ZIP 48466-589
Phone: (810) 378-4900
Fax: (810) 378-4905

The provider's authorized official is Kenneth Eugene Dambacher .
The authorized official title is Owner and has the following contact phone number (810) 378-4900.

The enumeration date for this NPI number is 6/18/2008 and was last updated on 11/10/2009.


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
1207Q00000XFamily Medicine5101008768MICHIGANYes

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
1114469926MEDICAIDMICHIGAN
25741038MEDICARE PINMICHIGAN
3E26231MEDICARE UPINMICHIGAN
4ON91670MEDICARE PINMICHIGAN
508-0G61059-0OTHERMICHIGANBLUE CROSS BLUE SHIELD OF MICHIGAN
65670042OTHERMICHIGANBLUE CROSS BLUE SHIELD OF MICHIGAN

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
Remove or sync iconNPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI
Next NPI »