Pine Medical Group PC

NPI #1093980187 in Fremont, Michigan

Provider Information

NPI Number: 1093980187
Entity Type: Organization
Organization Name: Pine Medical Group PC
Primary Specialty: Family Medicine
Enumeration Date: Apr 29, 2008
Last Updated: Feb 25, 2010

Practice Location

Address: 230 W OAK ST
City: Fremont
State: Michigan
ZIP Code: 49412-1575
Phone: (231) 924-4200

Authorized Official

Name: MRS. MARGE YOUNG
Title: ADMINISTRATOR
Phone: (231) 924-4200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X
Orthopaedic Surgery	207X00000X
Pediatrics	208000000X
Surgery	208600000X
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Family Medicine	207Q00000X	Primary

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