WEXFORD MEDICAL GROUP (NPI# 1093891939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093891939 |
| Entity Type | Organization |
| Organization Name | WEXFORD MEDICAL GROUP |
| Other Organization Name | GREAT LAKES FAMILY CARE |
| Practice Address |
520 Cobb St Cadillac MI 49601-2588 |
| Practice Telephone | 2317756521 |
| Practice Fax Number | 2318766519 |
| Mailing Telephone | 2317756521 |
| Mailing Fax Number | 2318766519 |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MICHAEL ZDRODOWSKI (ADMINISTRATOR) |
| Authorized Official Telephone | 2318766730 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| X | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | PPO LAB | 690H31500 | 01 |
| Other Name | Type Code |
|---|---|
| GREAT LAKES FAMILY CARE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508950767 | Wexford Medical Group | Family Medicine | 117 N Roland St, Mc Bain, MI 49657-9683 | 2006-10-03 |
| 1801972740 | Wexford Medical Group | Internal Medicine | 520 Cobb St, Cadillac, MI 49601-2588 | 2006-10-31 |
| 1366528200 | Wexford Medical Group | Family Medicine | 520 Cobb St, Cadillac, MI 49601-2588 | 2006-10-31 |
| 1124075809 | Wexford Medical Group | Internal Medicine | 520 Cobb St, Cadillac, MI 49601-2588 | 2006-05-28 |
| Street Address |
520 COBB ST |
| City | CADILLAC |
| State | MI |
| Zip Code | 49601-2588 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962405670 | Augustin Dolorfino | Pediatrics | 520 Cobb St, Cadillac, MI 49601-2588 | 2005-05-27 |
| 1457977175 | Lauren Herba | Dentist | 520 Cobb St, Cadillac, MI 49601-2588 | 2020-06-18 |
| 1306476213 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 520 Cobb St, Cadillac, MI 49601-2588 | 2020-01-20 |
| 1578112124 | Erin Kelle Gardner | Counselor | 520 Cobb St, Cadillac, MI 49601-2588 | 2019-09-06 |
| 1881197242 | Cheryl Lynn Dise | Dental Hygienist | 520 Cobb St, Cadillac, MI 49601-2588 | 2018-03-13 |
| 1790205870 | Joselyn M Verdelli | Dentist | 520 Cobb St, Cadillac, MI 49601-2588 | 2017-06-21 |
| 1275081820 | Andrew Goldin Mintzer | Dentist | 520 Cobb St, Cadillac, MI 49601-2588 | 2016-09-12 |
| 1588038095 | Sherry Ann Barnes | Counselor | 520 Cobb St, Cadillac, MI 49601-2588 | 2015-11-20 |
| 1255704144 | Thomas Mceldowney | Dental Hygienist | 520 Cobb St, Cadillac, MI 49601-2588 | 2015-11-02 |
| 1386021582 | Baldwin Family Health Care | Internal Medicine | 520 Cobb St, Cadillac, MI 49601-2588 | 2015-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720691983 | Hailey Amlott | Pharmacist | Walgreens 07660, 1220 N. Mitchell Street, Cadillac, MI 49601 | 2020-08-27 |
| 1558901454 | Diane Lyn Stearns | Physical Therapy Assistant | Samaritas Senior Living, 460 Pearl Street, Cadillac, MI 49601 | 2020-01-09 |
| 1902363013 | Marcella Marie Metzger | Pharmacist | 520 Cobb Street, Cadillac, MI 49601 | 2019-02-25 |
| 1558864447 | Tricia Wing | Physical Therapist | 704 Oak Street, Cadillac, MI 49601 | 2018-03-16 |
| 1386174134 | Marjorie Middel | Social Worker | 1909 N. Mitchell Street, Aleda E. Lutz Veterans Affairs Medical Center Cadillac, Cadillac, MI 49601 | 2017-06-14 |
| 1841726171 | T & M Helping Hand | Home Health | 325 Howard St, Cadillac, MI 49601 | 2017-05-05 |
| 1841731486 | Vicki Lynne Schutte | Behavior Technician | 7716 S. 27 Rd, Cadillac, MI 49601 | 2017-03-15 |
| 1518407220 | Rosanne Marie Denny | Behavior Technician | 605 Cadillac Shores Dr #106, Cadillac, MI 49601 | 2017-02-28 |
| 1821495532 | James David Shadoan | Family Medicine | 133 N. Shore Dr E., Cadillac, MI 49601 | 2014-11-24 |
| 1841632007 | Serenity Adult Foster Care Home LLC | Foster Care Agency | 2883 S. 41 Rd., Cadillac, MI 49601 | 2013-07-29 |
| Find all providers in zip 49601 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821495532 | James David Shadoan | Family Medicine | 133 N. Shore Dr E., Cadillac, MI 49601 | 2014-11-24 |
| 1477632842 | Kerry M Day-krusniak | Family Medicine | 7597 Mackinaw Trl, Cadillac, MI 49601-8422 | 2006-11-04 |
| 1912908252 | Gerald Dudek | Family Medicine | 827 E Division St, Cadillac, MI 49601-2015 | 2005-08-09 |
| 1316945017 | Tania M Lebaron | Family Medicine | 8950 Professional Dr, Cadillac, MI 49601-8599 | 2005-07-07 |
| 1295738060 | Douglas E Cox | Family Medicine | 7985 Mackinaw Trl, Cadillac, MI 49601-8111 | 2005-05-24 |
| 1740773456 | Amanda M Shoemaker | Family Medicine | 400 Hobart St, Cadillac, MI 49601-2331 | 2018-06-08 |
| 1164914214 | Natalie E Cook | Family Medicine | 400 Hobart St, Cadillac, MI 49601-2331 | 2018-06-05 |
| 1902398514 | Richard F Giannotti Jr. | Family Medicine | 400 Hobart St, Cadillac, MI 49601-2331 | 2018-05-31 |
| 1184116873 | Derek E Pyne | Family Medicine | 400 Hobart St, Cadillac, MI 49601-2331 | 2018-05-30 |
| 1750871117 | Munson Healthcare Cadillac | Family Medicine | 302 Hobart St, Cadillac, MI 49601-2379 | 2018-05-11 |
| Find all providers in CADILLAC | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.