| Cedar Run Family Medicine Center | |
|
520 S Williams St Mancelona MI 49659-9701 | |
| (231) 916-2024 | |
| (231) 916-2028 |
| Full Name | Cedar Run Family Medicine Center |
|---|---|
| Speciality | Family Medicine |
| Location | 520 S Williams St, Mancelona, Michigan |
| Authorized Official Name and Position | Thomas Laskey (OWNER) |
| Authorized Official Contact | 2319162024 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Run Family Medicine Center 520 S Williams St Mancelona MI 49659-9701 Ph: (231) 916-2024 | Cedar Run Family Medicine Center 520 S Williams St Mancelona MI 49659-9701 Ph: (231) 916-2024 |
| NPI Number | 1720269814 |
|---|---|
| Provider Enumeration Date | 11/17/2007 |
| Last Update Date | 11/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720269814 | NPI | - | NPPES |
| 4748889 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301085556 (Michigan) | Primary |
Mancelona Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 419 W State St, Mancelona, MI 49659 Phone: 231-587-9181 | |
Mancelona Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 419 W State St, Mancelona, MI 49659 Phone: 231-587-9181 Fax: 231-587-0923 |