Provider Demographics
NPI:1417279407
Name:APPLE FAMILY MEDICINE, P.L.C.
Entity Type:Organization
Organization Name:APPLE FAMILY MEDICINE, P.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:PLINE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-420-6817
Mailing Address - Street 1:1042 S RAVENNA RD
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:MI
Mailing Address - Zip Code:49451
Mailing Address - Country:US
Mailing Address - Phone:517-420-6817
Mailing Address - Fax:
Practice Address - Street 1:1042 S RAVENNA RD
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:MI
Practice Address - Zip Code:49451
Practice Address - Country:US
Practice Address - Phone:517-420-6817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017025261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care