Provider Demographics
NPI:1801813373
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 1:211 S CRAPO ST
Practice Address - Street 2:SUITE J
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2961
Practice Address - Country:US
Practice Address - Phone:989-773-0623
Practice Address - Fax:989-779-7817
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MYMICHIGAN MEDICAL CENTER ALMA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-17
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207Q00000X, 207RC0200X, 207RP1001X, 207RS0012X, 363L00000X
207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0C71014OtherBCBSM GROUP
MICI7713Medicare PIN
MI0N71730Medicare PIN
MIDA0448Medicare PIN
MIDA1187Medicare PIN
MI0C71014OtherBCBSM GROUP