| Michigan Community Medical Clinic | |
|
115 So St. # 290 Michigan ND 58259 | |
| (701) 259-2118 | |
| (701) 259-2319 |
| Full Name | Michigan Community Medical Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 115 So St. # 290, Michigan, North Dakota |
| Authorized Official Name and Position | Nathan Boyd Hagen (PHYSICIAN) |
| Authorized Official Contact | 7012592118 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Community Medical Clinic Po Box 290 115 So St. # 290 Michigan ND 58259 Ph: (701) 259-2118 | Michigan Community Medical Clinic 115 So St. # 290 Michigan ND 58259 Ph: (701) 259-2118 |
| NPI Number | 1427466630 |
|---|---|
| Provider Enumeration Date | 07/31/2014 |
| Last Update Date | 07/31/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427466630 | NPI | - | NPPES |
| 11257 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 3113 (North Dakota) | Primary |
Nelson County Health System Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 115 South St E, Michigan, ND 58259 Phone: 701-259-2118 |