| Cedar Hill Medical Pc | |
|
2845 Us Highway 2/41 Suite 201 Bark River MI 49807-9661 | |
| (906) 466-2000 | |
| (906) 466-2027 |
| Full Name | Cedar Hill Medical Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2845 Us Highway 2/41, Bark River, Michigan |
| Authorized Official Name and Position | Theodore Matthew Oswald (DIRECT OWNER) |
| Authorized Official Contact | 9064662000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Hill Medical Pc 2845 Us Highway 2/41 Suite 201 Bark River MI 49807-9661 Ph: (906) 466-2000 | Cedar Hill Medical Pc 2845 Us Highway 2/41 Suite 201 Bark River MI 49807-9661 Ph: (906) 466-2000 |
| NPI Number | 1932249984 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 03/15/2018 |
| Medicare PECOS PAC ID | 5395840672 |
|---|---|
| Medicare Enrollment ID | O20070416000077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932249984 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301076738 (Michigan) | Primary |
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Secondary |
| Provider Name | Carolyn Ruth Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639188253 PECOS PAC ID: 7517856248 Enrollment ID: I20040311001118 |
| Provider Name | Chickamagalur N Raveesh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427043843 PECOS PAC ID: 5092795807 Enrollment ID: I20040722000676 |
| Provider Name | Theodore Matthew Oswald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801805528 PECOS PAC ID: 8820193113 Enrollment ID: I20070416000115 |
| Provider Name | Clara E Schultz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841579828 PECOS PAC ID: 1951571579 Enrollment ID: I20110908002011 |
| Provider Name | Jenni L Polfus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548703218 PECOS PAC ID: 3072893916 Enrollment ID: I20161209001542 |
| Provider Name | Nicole Marie Madalinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952879025 PECOS PAC ID: 9032454079 Enrollment ID: I20181220000692 |