NORTHWEST MICHIGAN HEART & VASCULAR SPECIALISTS (NPI# 1245497858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245497858 |
| Entity Type | Organization |
| Organization Name | NORTHWEST MICHIGAN HEART & VASCULAR SPECIALISTS |
| Practice Address |
3529 W Front St Suite B Traverse City MI 49684-9689 |
| Mailing Address |
2393 Momentum Pl Chicago IL 60689-0001 |
| Practice Telephone | 2319350335 |
| Practice Fax Number | 2319350336 |
| Mailing Telephone | 2319350335 |
| Mailing Fax Number | 2319350336 |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-08-14 |
| Authorized Official Name | DR. MICHAEL A LAUER (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 2319350335 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
4301075408 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CARE NETWORK | 0281087 | 01 |
| MI | BCBS OF MICH | 0281087 | 01 |
| MI | BCBS OF MICH | 0602810871 | 01 |
| MI | 1407890536 | 05 | |
| MI | BLUE CARE NETWORK | 0602810871 | 01 |
| MI | CORP NPI | 1245497858 | 01 |
| MI | INDIVIDUAL NPI | 1407890536 | 01 |
| MI | 1245497858 | 05 |
| Street Address |
3529 W FRONT ST SUITE B |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-9689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568457174 | John E. Raftery | Internal Medicine | 1200 6th St, Traverse City, MI 49684-2369 | 2005-09-20 |
| 1508851155 | Michael E Schulte | Internal Medicine | 1200 6th St Ste 200, Traverse City, MI 49684-2369 | 2005-09-20 |
| 1063407799 | Brian D Jaffe | Internal Medicine | 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 | 2005-09-19 |
| 1174522429 | Steven T Mast | Internal Medicine | 1200 Sixth St, Suite 200, Traverse City, MI 49684-2369 | 2005-07-19 |
| 1821398322 | Munson Medical Group | Internal Medicine | 1200 Sixth St, Suite 200, Traverse City, MI 49684-2369 | 2010-10-30 |
| 1730343583 | Kristen N. Maurice | Internal Medicine | 1200 Sixth St Ste 200, Traverse City, MI 49684-2369 | 2008-07-10 |
| 1114127198 | Michael Howe | Internal Medicine | 1200 Sixth St, Suite 200, Traverse City, MI 49684-2369 | 2007-07-19 |
| 1144433277 | Todd R Adams | Internal Medicine | 1200 Sixth St, Suite 200, Traverse City, MI 49684-2369 | 2007-05-07 |
| 1295873388 | Nicklaus Karwas Slocum | Internal Medicine | 1200 Sixth St, Suite 200, Traverse City, MI 49684-2369 | 2007-02-02 |
| 1487683504 | Great Lakes Cardiology, P.C. | Internal Medicine | 1221 6th St, Suite 204, Traverse City, MI 49684-2359 | 2006-07-01 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
Please comment or provide details below to improve the information on NORTHWEST MICHIGAN HEART & VASCULAR SPECIALISTS.
| 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.