Central Michigan University

NPI #1790058386 in Mount Pleasant, Michigan

Provider Information

NPI Number: 1790058386
Entity Type: Organization
Organization Name: Central Michigan University
Primary Specialty: Surgery
Enumeration Date: Feb 14, 2012
Last Updated: Oct 22, 2014

Practice Location

Address: 2981 HEALTH PKWY
Address 2: SUITE B
City: Mount Pleasant
State: Michigan
ZIP Code: 48858-9347
Phone: (989) 772-6880

Authorized Official

Name: MR. KELLY J GRONDA
Title: PROVIDER ENROLLMENT SPECIALIST
Phone: (989) 774-3334

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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