| George J Carley Do Pc | |
|
1943 Holland Ave Port Huron MI 48060-1519 | |
| (810) 985-5700 | |
| (810) 985-5454 |
| Full Name | George J Carley Do Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1943 Holland Ave, Port Huron, Michigan |
| Authorized Official Name and Position | George J Carley (OWNER/PHYSICIAN) |
| Authorized Official Contact | 8109855700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| George J Carley Do Pc 1943 Holland Ave Port Huron MI 48060-1519 Ph: (810) 985-5700 | George J Carley Do Pc 1943 Holland Ave Port Huron MI 48060-1519 Ph: (810) 985-5700 |
| NPI Number | 1528173812 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 06/13/2008 |
| Medicare PECOS PAC ID | 9739154337 |
|---|---|
| Medicare Enrollment ID | O20040827000493 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528173812 | NPI | - | NPPES |
| 4463388 | Medicaid | MI | |
| DE0592 | Other | MI | MEDICARE TRAVELLERS RR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | GC011673 (Michigan) | Primary |
| 207Q00000X | Family Medicine | RS074708 (Michigan) | Secondary |
| 207Q00000X | Family Medicine | JB070145 (Michigan) | Secondary |
| Provider Name | Reid S Stromberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417062761 PECOS PAC ID: 7517934227 Enrollment ID: I20040913000989 |
| Provider Name | George J Carley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386668689 PECOS PAC ID: 3072588672 Enrollment ID: I20050406000358 |
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