| Munson Healthcare Charlevoix Hospital | |
| 
					223 N Park St Boyne City MI 49712-1220  | |
| (231) 582-5314 | |
| (231) 582-5338 | 
| Full Name | Munson Healthcare Charlevoix Hospital | 
|---|---|
| Speciality | Family Medicine | 
| Location | 223 N Park St, Boyne City, Michigan | 
| Authorized Official Name and Position | Bonnie Kruszka (COO MUNSON PHYSICIAN NETWORK) | 
| Authorized Official Contact | 2319354995 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Munson Healthcare Charlevoix Hospital 223 N Park St Boyne City MI 49712-1220 Ph: (231) 582-5314  | Munson Healthcare Charlevoix Hospital 223 N Park St Boyne City MI 49712-1220 Ph: (231) 582-5314  | 
| NPI Number | 1790867216 | 
|---|---|
| Provider Enumeration Date | 10/20/2006 | 
| Last Update Date | 10/02/2024 | 
| Medicare PECOS PAC ID | 4284528035 | 
|---|---|
| Medicare Enrollment ID | O20070109000030 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1790867216 | NPI | - | NPPES | 
| 0A51004 | Other | MI | BCN FP PROFESSIONAL GRP | 
| 31459366 | Other | MI | FIRST HEALTH FP GROUP | 
| 900001729 | Other | MI | PRIORITY HEALTH FP GROUP | 
| 0A51004 | Other | MI | BLUE SHIELD FP GROUP | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (Michigan) | Primary | 
| Provider Name | Christina Dalton Pryde | 
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) | 
| Provider Identifiers | NPI Number: 1033103874 PECOS PAC ID: 9638068125 Enrollment ID: I20040312000648  | 
| Provider Name | Steven A Voci | 
|---|---|
| Provider Type | Practitioner - Optometry | 
| Provider Identifiers | NPI Number: 1548240260 PECOS PAC ID: 7911994009 Enrollment ID: I20040429000939  | 
| Provider Name | Loren M Wise | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1972573442 PECOS PAC ID: 3274592688 Enrollment ID: I20041008001435  | 
| Provider Name | Mark C Antonishen | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1518971654 PECOS PAC ID: 7315916590 Enrollment ID: I20050602000214  | 
| Provider Name | Dale D Owen | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1295803138 PECOS PAC ID: 5890876114 Enrollment ID: I20080112000141  | 
| Provider Name | Catherine A Wonski | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1386755726 PECOS PAC ID: 7214067578 Enrollment ID: I20100611000833  | 
| Provider Name | Andrea L Wendling | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1992816334 PECOS PAC ID: 4587794847 Enrollment ID: I20100611000840  | 
| Provider Name | Michael J Harmeling | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1194836502 PECOS PAC ID: 9931239290 Enrollment ID: I20100611000846  | 
| Provider Name | Lori A Katzman | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1467516476 PECOS PAC ID: 9931397510 Enrollment ID: I20101223000273  | 
| Provider Name | Michael J Lucido | 
|---|---|
| Provider Type | Practitioner - Clinical Psychologist | 
| Provider Identifiers | NPI Number: 1760623433 PECOS PAC ID: 2466686209 Enrollment ID: I20131009001404  | 
| Provider Name | Glen Macpherson | 
|---|---|
| Provider Type | Practitioner - Preventive Medicine | 
| Provider Identifiers | NPI Number: 1467429050 PECOS PAC ID: 0446387252 Enrollment ID: I20150806011036  | 
| Provider Name | Maurica Cox | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1699155671 PECOS PAC ID: 3274840632 Enrollment ID: I20150916003406  | 
| Provider Name | Alan G Smith | 
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) | 
| Provider Identifiers | NPI Number: 1376908863 PECOS PAC ID: 5092011445 Enrollment ID: I20160310000647  | 
| Provider Name | Sarah Kay Wolf | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1952727653 PECOS PAC ID: 4789805292 Enrollment ID: I20170825003419  | 
| Provider Name | Rachel J Burmeister | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1811544703 PECOS PAC ID: 0749510592 Enrollment ID: I20190923000722  | 
| Provider Name | Shannon Marie Hicks | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1871143685 PECOS PAC ID: 2365871209 Enrollment ID: I20200329000366  | 
| Provider Name | Caitlyn Monks | 
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology | 
| Provider Identifiers | NPI Number: 1558710590 PECOS PAC ID: 2860817798 Enrollment ID: I20200810000438  | 
| Provider Name | Trisha Tomkins | 
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology | 
| Provider Identifiers | NPI Number: 1518329317 PECOS PAC ID: 2466745435 Enrollment ID: I20240520001932  | 
Mclaren Central Michigan Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1249 S M 75, Boyne City, MI 49712 Phone: 231-582-1515  | |
Munson Healthcare Charlevoix Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 223 N Park St, Boyne City, MI 49712 Phone: 231-582-5314 Fax: 231-582-5338  | |
Mclaren Central Michigan Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1249 S M 75, Boyne City, MI 49712 Phone: 231-582-2425  |