| Blue Water Medical Pllc | |
|
511 Fort St Suite 102 Port Huron MI 48060-3922 | |
| (810) 479-4769 | |
| (888) 414-4545 |
| Full Name | Blue Water Medical Pllc |
|---|---|
| Speciality | Clinic/center |
| Location | 511 Fort St, Port Huron, Michigan |
| Authorized Official Name and Position | Marcus K. Free (PRESIDENT/MEMBER) |
| Authorized Official Contact | 8104794769 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Water Medical Pllc 511 Fort St Suite 102 Port Huron MI 48060-3922 Ph: (810) 479-4769 | Blue Water Medical Pllc 511 Fort St Suite 102 Port Huron MI 48060-3922 Ph: (810) 479-4769 |
| NPI Number | 1336409192 |
|---|---|
| Provider Enumeration Date | 05/25/2012 |
| Last Update Date | 05/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336409192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4301093347 (Michigan) | Primary |
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