Provider Demographics
NPI:1821143546
Name:FINN, J. PATRICK (PAC)
Entity Type:Individual
Prefix:
First Name:J.
Middle Name:PATRICK
Last Name:FINN
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E WARWICK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1083
Mailing Address - Country:US
Mailing Address - Phone:989-463-6092
Mailing Address - Fax:
Practice Address - Street 1:315 E WARWICK DR
Practice Address - Street 2:SUITE A
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1083
Practice Address - Country:US
Practice Address - Phone:989-463-6092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601001484363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N59350Medicare ID - Type Unspecified