Provider Demographics
NPI:1194024042
Name:INDIGO HOSPITAL MEDICINE - IRON MOUNTAIN PLC
Entity Type:Organization
Organization Name:INDIGO HOSPITAL MEDICINE - IRON MOUNTAIN PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR. REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCMORROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-346-6807
Mailing Address - Street 1:10850 E. TRAVERSE HWY.
Mailing Address - Street 2:STE. 4400
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-1320
Mailing Address - Country:US
Mailing Address - Phone:231-346-6800
Mailing Address - Fax:231-346-6052
Practice Address - Street 1:1721 S STEPHENSON AVE
Practice Address - Street 2:
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801-3637
Practice Address - Country:US
Practice Address - Phone:906-776-5415
Practice Address - Fax:906-776-5402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty