Provider Demographics
NPI:1588854475
Name:ALMA COLLEGE
Entity Type:Organization
Organization Name:ALMA COLLEGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. ADMINISTRATION/FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BUHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-463-7143
Mailing Address - Street 1:614 W SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1504
Mailing Address - Country:US
Mailing Address - Phone:989-463-7143
Mailing Address - Fax:989-463-7094
Practice Address - Street 1:614 W SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1504
Practice Address - Country:US
Practice Address - Phone:989-463-7143
Practice Address - Fax:989-463-7094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI080B9105200OtherBCBSM
MI5212023-11Medicaid
MI080B9105200OtherBCBSM