Provider Demographics
NPI:1922153311
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 1:2621 W WACKERLY ST
Practice Address - Street 2:SUITE C
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6993
Practice Address - Country:US
Practice Address - Phone:989-837-6505
Practice Address - Fax:989-835-8428
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MYMICHIGAN MEDICAL CENTER ALMA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-24
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty