| Gateway Healthcare | |
|
1549 Washington St Midland MI 48640-5685 | |
| (989) 259-1000 | |
| (989) 402-0097 |
| Full Name | Gateway Healthcare |
|---|---|
| Speciality | General Practice |
| Location | 1549 Washington St, Midland, Michigan |
| Authorized Official Name and Position | James Mier (CLINIC DIRECTOR) |
| Authorized Official Contact | 9892591000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Healthcare 1549 Washington St Midland MI 48640-5685 Ph: (989) 259-1000 | Gateway Healthcare 1549 Washington St Midland MI 48640-5685 Ph: (989) 259-1000 |
| NPI Number | 1508519414 |
|---|---|
| Provider Enumeration Date | 01/31/2022 |
| Last Update Date | 09/27/2023 |
| Certification Date | 09/27/2023 |
| Medicare PECOS PAC ID | 4284028481 |
|---|---|
| Medicare Enrollment ID | O20220304001151 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508519414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (NU) | Primary |
| Provider Name | John E Roberts |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194758920 PECOS PAC ID: 8224190244 Enrollment ID: I20081229000175 |
| Provider Name | Shawn E Bunch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851584494 PECOS PAC ID: 2062576523 Enrollment ID: I20140220001104 |
| Provider Name | Charlene D Dengler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700623238 PECOS PAC ID: 9234670233 Enrollment ID: I20240918000613 |
| Provider Name | Mckenzie Wilkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114746690 PECOS PAC ID: 7113450685 Enrollment ID: I20241023002116 |
| Provider Name | Kimberly Lynne Weihl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528773991 PECOS PAC ID: 7911434899 Enrollment ID: I20241217003744 |
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