Provider Demographics
NPI:1669548061
Name:MYMICHIGAN MEDICAL CENTER SAGINAW
Entity type:Organization
Organization Name:MYMICHIGAN MEDICAL CENTER SAGINAW
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER PATIENT ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
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:48670-2000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1212 W SAGINAW RD
Practice Address - Street 2:
Practice Address - City:VASSAR
Practice Address - State:MI
Practice Address - Zip Code:48768-9483
Practice Address - Country:US
Practice Address - Phone:989-823-5020
Practice Address - Fax:989-823-7881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704173083363LF0000X
MI4301079750207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P11730OtherMEDICARE GROUP DR SARKAR
MI4708328Medicaid
MIM10200918OtherDR SARKAR TRICARE
MIM10200335OtherJILL MOORE NP TRICARE
MI01001177OtherHEALTHPLUS
MI150533OtherJILL MOORE NP GREATLAKES
MI151305OtherDR SARKAR GREATLAKES MCD
MI0807911002OtherBCBS
MI0807911002OtherBCN
MI4771591Medicaid
MIM10200335OtherJILL MOORE NP TRICARE
MIM10200918OtherDR SARKAR TRICARE
MI0807911002OtherBCBS
MI4771591Medicaid