| Carlson Medical Pc | |
|
S926 Us 41 Stephenson MI 49887 | |
| (906) 753-4665 | |
| (906) 753-4366 |
| Full Name | Carlson Medical Pc |
|---|---|
| Speciality | Family Medicine |
| Location | S926 Us 41, Stephenson, Michigan |
| Authorized Official Name and Position | Vernette M Carlson (PRESIDENT CARLSON MEDICAL PC) |
| Authorized Official Contact | 9067534665 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carlson Medical Pc Po Box 400 S926 Us Hwy 41 Stephenson MI 49887-0400 Ph: (906) 753-4665 | Carlson Medical Pc S926 Us 41 Stephenson MI 49887 Ph: (906) 753-4665 |
| NPI Number | 1811183163 |
|---|---|
| Provider Enumeration Date | 09/20/2007 |
| Last Update Date | 11/28/2007 |
| Medicare PECOS PAC ID | 6305810250 |
|---|---|
| Medicare Enrollment ID | O20040825000802 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811183163 | NPI | - | NPPES |
| 4654290 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 048831 (Michigan) | Primary |
| Provider Name | Vernette M Carlson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356440176 PECOS PAC ID: 4183614464 Enrollment ID: I20040518000100 |
| Provider Name | Renee L Haberland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972044014 PECOS PAC ID: 1254605132 Enrollment ID: I20170915000211 |