| Harbors North Llc | |
|
3890 Charlevoix Rd Ste 210 Petoskey MI 49770-8420 | |
| (231) 445-1898 | |
| Not Available |
| Full Name | Harbors North Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3890 Charlevoix Rd Ste 210, Petoskey, Michigan |
| Authorized Official Name and Position | Ryan Schelldorf (PRESIDENT) |
| Authorized Official Contact | 2314451898 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harbors North Llc 1 Altair Dr Boyne City MI 49712-9618 Ph: (231) 445-1898 | Harbors North Llc 3890 Charlevoix Rd Ste 210 Petoskey MI 49770-8420 Ph: (231) 445-1898 |
| NPI Number | 1407677990 |
|---|---|
| Provider Enumeration Date | 10/18/2024 |
| Last Update Date | 12/19/2024 |
| Certification Date | 12/19/2024 |
| Medicare PECOS PAC ID | 4082136478 |
|---|---|
| Medicare Enrollment ID | O20250314000832 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407677990 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Matthew Mckenna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578729588 PECOS PAC ID: 6002053287 Enrollment ID: I20190515000634 |
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