Mclaren Bay Region

NPI #1134408511 in Fairview, Michigan

Provider Information

NPI Number: 1134408511
Entity Type: Organization
Organization Name: Mclaren Bay Region
Primary Specialty: Family Medicine
Enumeration Date: Aug 16, 2011
Last Updated: Aug 7, 2018

Practice Location

Address: 1910 E MILLER RD
City: Fairview
State: Michigan
ZIP Code: 48621
Phone: (989) 848-5484

Authorized Official

Name: DANIELLE C JACKS PORTER
Title: CFO
Phone: (989) 894-3838

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Physician Assistant	363A00000X
Nurse Practitioner - Family — Family	363LF0000X
Nurse Practitioner - Gerontology — Gerontology	363LG0600X
Nurse Practitioner - Pediatrics — Pediatrics	363LP0200X
Family Medicine	207Q00000X	Primary

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