| Jared Davis, DO | |
|
1000 Harrington St, Mount Clemens, MI 48043 | |
| (586) 493-8000 | |
| Not Available |
| Full Name | Jared Davis |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 8 Years |
| Location | 1000 Harrington St, Mount Clemens, 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 |
|---|---|---|---|
| 1114459476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 5101027013 (Michigan) | Primary |
| 208800000X | Urology | 5101023055 (Michigan) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Charlevoix Area Hospital | Charlevoix, MI | Hospital |
| Munson Medical Center | Traverse city, MI | Hospital |
| Munson Healthcare Otsego Memorial Hospital | Gaylord, MI | Hospital |
| Chippewa County War Memorial Hospital | Sault sainte marie, MI | Hospital |
| Mclaren Northern Michigan | Petoskey, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Munson Healthcare Charlevoix Hospital | 4284528035 | 43 |
| Munson Healthcare Otsego Memorial Hospital | 8325942535 | 78 |
| 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 |
| Entity Name | Munson Healthcare Charlevoix Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629154307 PECOS PAC ID: 4284528035 Enrollment ID: O20071011000237 |
| Mailing Address | Practice Location Address |
|---|---|
| Jared Davis, DO 1000 Harrington Boulevard, Mount Clemens, MI 48043 Ph: () - | Jared Davis, DO 1000 Harrington St, Mount Clemens, MI 48043 Ph: (586) 493-8000 |
Kevin Kunitsky, DO Urology Medicare: Medicare Enrolled Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-790-9003 | |
Andrew Mcclendon Hall, DO Urology Medicare: Medicare Enrolled Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-790-9003 | |
Amanda Obi, DO Urology Medicare: Medicare Enrolled Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-790-9003 |