| Sally Ann Ancel, DO | |
| 
					1105 6th St, Traverse City, MI 49684-2349  | |
| (231) 947-0673 | |
| (801) 740-2847 | 
| Full Name | Sally Ann Ancel | 
|---|---|
| Gender | Female | 
| Speciality | Emergency Medicine | 
| Location | 1105 6th St, Traverse City, Michigan | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1811000466 | NPI | - | NPPES | 
| SA013590 | Other | BCBS | |
| 114951830 | Medicaid | MI | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207P00000X | Emergency Medicine | 5101013590 (Michigan) | Primary | 
| Entity Name | Kalkaska Memorial Health Center | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1013183060 PECOS PAC ID: 3577536002 Enrollment ID: O20040813000668  | 
| Entity Name | Northwestern Michigan Emergency Physicians Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1073597944 PECOS PAC ID: 7214933928 Enrollment ID: O20061019000359  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Sally Ann Ancel, DO 419 S Coral St, Kalkaska, MI 49646-2503 Ph: (231) 258-7502  | Sally Ann Ancel, DO 1105 6th St, Traverse City, MI 49684-2349 Ph: (231) 947-0673  | 
Bevin Clayton, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1105 6th St, Traverse City, MI 49684 Phone: 231-947-0673 Fax: 801-740-2847  | |
Dale C Blum, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1105 6th St, Traverse City, MI 49684 Phone: 231-947-0673 Fax: 801-740-2847  | |
Dr. Brandi Jenks Gunn, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1105 6th St, Traverse City, MI 49684 Phone: 231-947-0673 Fax: 801-740-2847  | |
Richard G Faller, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1105 6th St, Traverse City, MI 49684 Phone: 231-947-0673 Fax: 801-740-2847  | |
David Darwin Nicolaou, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 550 Munson Ave, Traverse City, MI 49686 Phone: 231-935-8710  | |
David Shapiro, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1105 Sixth St, Traverse City, MI 49684 Phone: 231-395-6333 Fax: 801-740-2847  | |
Juhn Mark Han,  Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1105 6th St, Traverse City, MI 49684 Phone: 231-947-0673  |