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GREAT LAKES PLASTIC SURGERY CENTER NPI 1972795334


NPI Information

NPI: 1972795334
Provider Name: GREAT LAKES PLASTIC SURGERY CENTER
Classification: Surgery - 2086S0122X
Entity Type: Organization

Specialization: Plastic and Reconstructive Surgery

Address:
5085 ANNA DR
TRAVERSE CITY, MI
ZIP 49684
Phone: (231) 935-0180
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GREAT LAKES PLASTIC SURGERY CENTER is a plastic and reconstructive surgery surgery in Traverse City, MI. The provider is a surgeon who specializes in plastic and reconstructive surgery. GREAT LAKES PLASTIC SURGERY CENTER NPI is 1972795334. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

5085 ANNA DR
TRAVERSE CITY, MI
ZIP 49684-691
Phone: (231) 935-0180
Fax: (231) 935-0099

The provider's authorized official is Catherine S Francis .
The authorized official title is Medical Biller and has the following contact phone number (231) 935-0180.

The enumeration date for this NPI number is 8/9/2007 and was last updated on 8/18/2009.


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
1363L00000XNurse PractitionerNo
22086S0122XSurgeryPlastic and Reconstructive SurgeryYes

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
10M91950MEDICARE UPINMICHIGAN
20M67020MEDICARE UPINMICHIGAN
31285614032OTHERMICHIGANNPI
43495242MEDICAIDMICHIGAN
56247900001MEDICARE NSCMICHIGAN
64156180MEDICAIDMICHIGAN
74704192319OTHERMICHIGANSTATE LICENSE
81437139318OTHERMICHIGANNPI
95008762590OTHERMICHIGANBLUE CROSS BLUE SHIELD MI
102402810821OTHERMICHIGANBLUE CROSS BLUE SHIELD MI
114301067433OTHERMICHIGANSTATE LICENSE

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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