Provider Demographics
NPI:1750366217
Name:N'ORTHOPEDICS PC
Entity type:Organization
Organization Name:N'ORTHOPEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-732-1753
Mailing Address - Street 1:2147 PROFESSIONAL DR
Mailing Address - Street 2:PO BOX 340
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-0003
Mailing Address - Country:US
Mailing Address - Phone:989-732-1753
Mailing Address - Fax:989-731-1425
Practice Address - Street 1:2147 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-0003
Practice Address - Country:US
Practice Address - Phone:989-732-1753
Practice Address - Fax:989-731-1425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-07
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1356544Medicaid
MI4888932Medicaid
MIC20677OtherRAILROAD MEDICARE
MICB0014OtherRAILROAD MEDICARE
MI4389576Medicaid
MI4945654Medicaid
MI1915384Medicaid
MIP09680001Medicare ID - Type UnspecifiedSHELLY R. SLIVINSKI PA-C
MI4888932Medicaid
MI4389576Medicaid
0P09680Medicare PIN