Provider Demographics
NPI:1710105572
Name:MERCY GENERAL HEALTH PARTNERS
Entity Type:Organization
Organization Name:MERCY GENERAL HEALTH PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MEDICAL EDUCATION
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:DORA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:231-672-6363
Mailing Address - Street 1:1700 OAK AVE STE 007
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-2407
Mailing Address - Country:US
Mailing Address - Phone:231-672-6451
Mailing Address - Fax:231-672-6465
Practice Address - Street 1:1700 OAK AVE STE 007
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-2407
Practice Address - Country:US
Practice Address - Phone:231-672-6451
Practice Address - Fax:231-672-6465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017069281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital