Provider Demographics
NPI:1699854059
Name:SVINARICH, LAURA MICHELE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MICHELE
Last Name:SVINARICH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:MICHELE
Other - Last Name:MCCLELLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5340 N GENESEE RD
Mailing Address - Street 2:STE B
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48506-4529
Mailing Address - Country:US
Mailing Address - Phone:810-793-8828
Mailing Address - Fax:810-424-4948
Practice Address - Street 1:5100 GATEWAY CTR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3927
Practice Address - Country:US
Practice Address - Phone:810-733-6480
Practice Address - Fax:810-733-6483
Is Sole Proprietor?:No
Enumeration Date:2006-11-04
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601003786363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical