| Dr Keith Y Miyamoto, MD | |
|
829 N Center Ave, Suite 160, Gaylord, MI 49735-1595 | |
| (989) 731-7131 | |
| (989) 731-6415 |
| Full Name | Dr Keith Y Miyamoto |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 54 Years |
| Location | 829 N Center Ave, Gaylord, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609883842 | NPI | - | NPPES |
| OF96004 | Other | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 4301032171 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Munson Healthcare Otsego Memorial Hospital | Gaylord, MI | Hospital |
| Mclaren Northern Michigan | Petoskey, MI | Hospital |
| Munson Medical Center | Traverse city, MI | Hospital |
| Munson Healthcare Grayling Hospital | Grayling, MI | Hospital |
| Kalkaska Memorial Health Center | Kalkaska, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Munson Healthcare Otsego Memorial Hospital | 8325942535 | 119 |
| Entity Name | Munson Healthcare Otsego Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164628426 PECOS PAC ID: 8325942535 Enrollment ID: O20040305000525 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Keith Y Miyamoto, MD 829 N Center Ave, Suite 298, Gaylord, MI 49735-1595 Ph: (989) 731-7708 | Dr Keith Y Miyamoto, MD 829 N Center Ave, Suite 160, Gaylord, MI 49735-1595 Ph: (989) 731-7131 |
Matthew Boudreau Ayres, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 829 N Center Ave Ste 260, Gaylord, MI 49735 Phone: 989-731-6405 Fax: 989-731-6415 |