Provider Demographics
NPI:1407938590
Name:MYMICHIGAN MEDICAL CENTER ALMA
Entity Type:Organization
Organization Name:MYMICHIGAN MEDICAL CENTER ALMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER PATIENT ACCOUNTS
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEIRCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-356-7597
Mailing Address - Street 1:4000 WELLNESS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48670-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8776 E HOWARD CITY EDMORE RD
Practice Address - Street 2:
Practice Address - City:VESTABURG
Practice Address - State:MI
Practice Address - Zip Code:48891-9406
Practice Address - Country:US
Practice Address - Phone:989-268-3071
Practice Address - Fax:989-268-9632
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MYMICHIGAN MEDICAL CENTER ALMA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-19
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E91019OtherBCBSM GROUP
MICI7713Medicare PIN
MI0N74560Medicare PIN
MI0E91019OtherBCBSM GROUP
MI0M17400Medicare PIN