EAST BAY MEDICAL CENTER, P.C. (NPI# 1851599054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851599054 |
| Entity Type | Organization |
| Organization Name | EAST BAY MEDICAL CENTER, P.C. |
| Practice Address |
1401 Short Dr Prudenville MI 48651-8436 |
| Mailing Address |
Po Box 19 1401 Short Drive Prudenville MI 48651-8436 |
| Practice Telephone | 9893661515 |
| Practice Fax Number | 9893661501 |
| Mailing Telephone | 9893661515 |
| Mailing Fax Number | 9893661501 |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2013-06-12 |
| Authorized Official Name | SUZANNE ALAINE BLANCHARD (OWNER) |
| Authorized Official Telephone | 9893661515 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
4704203066 | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS BLUE SHIELD | 5008702190 | 01 |
| MI | 4577440 | 05 |
| Street Address |
1401 SHORT DR |
| City | PRUDENVILLE |
| State | MI |
| Zip Code | 48651-8436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710469036 | Stephenie Irish | Behavior Technician | Rise Center for Autism, 1840 West Houghton Lake Dr Unit 2, Prudenville, MI 48651 | 2018-09-04 |
| 1083965404 | Mercy Physician Network | Clinic/Center | 2585 W Houghton Lake Drive, Prudenville, MI 48651 | 2012-09-25 |
| 1609976968 | Kronner Pharmacy Inc | Pharmacy | 778 W Houghton Lake Dr, Prudenville, MI 48651 | 2006-09-25 |
| 1255352936 | Mclaren Primary Care | Family Medicine | 200 N. Grand Ave, Prudenville, MI 48651 | 2006-07-21 |
| 1053381871 | Marvin Earl Mcelroy | Internal Medicine | 1064 W West Branch Rd, Prudenville, MI 48651 | 2006-01-24 |
| 1598390080 | Rhiannon Burch | Behavior Technician | Rise Center for Autism, 1070 W. Houghton Lake Drive, Prudenville, MI 48651 | 2020-03-05 |
| 1629357090 | Mclaren Bay Region | Nurse Practitioner | 200 Grand Ave, Prudenville, MI 48651 | 2011-08-16 |
| 1427320894 | Patricia Henning Caswell | Counselor | 1401 Short Dr., Prudenville, MI 48651-0019 | 2012-02-01 |
| 1023015104 | Suzanne A Blanchard | Nurse Practitioner | 1401 Short Drive, Prudenville, MI 48651-0019 | 2005-07-05 |
| 1023640992 | Julie Ignatowski | Speech-Language Pathologist | 847 Springwood Dr, Prudenville, MI 48651-8405 | 2020-02-10 |
| Find all providers in zip 48651 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083965404 | Mercy Physician Network | Clinic/Center | 2585 W Houghton Lake Drive, Prudenville, MI 48651 | 2012-09-25 |
| 1184977811 | Mercy Physician Network | Clinic/Center | 2585 W Houghton Lake Dr, Prudenville, MI 48651-9624 | 2012-10-18 |
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|---|---|---|---|---|
| 1487252458 | Midland Express Urgent and Family Care | Clinic/Center | 600 Cambridge St Ste 1, Midland, MI 48642-4508 | 2020-10-13 |
| 1841805306 | Alex Wagner, LLC | Clinic/Center | 1864 Lakeshore Dr Ste A, Muskegon, MI 49441-1607 | 2020-09-11 |
| 1760013262 | Tranquility Wellness Center | Clinic/Center | 5237 Oakman Blvd Ste B100, Dearborn, MI 48126-4045 | 2020-02-03 |
| 1588295463 | Scheurer Hospital | Clinic/Center | 100 Pigeon Rd Ste C, Bad Axe, MI 48413-8169 | 2020-01-30 |
| 1639718539 | Scheurer Hospital | Clinic/Center | 75 Buschlen Rd, Bad Axe, MI 48413 | 2019-12-26 |
| 1780235465 | Careatc | Clinic/Center | 2221 Health Dr Sw Ste 1500, Grand Rapids, MI 49519-9681 | 2019-09-24 |
| 1821649948 | Hope Primary Care of Birch Run Pllc | Clinic/Center | 9143 Birh Run Rd, Ste 3, Birch Run, MI 48415 | 2019-09-20 |
| 1609425180 | Wafa A Elhassan Md Pllc | Clinic/Center | 1905 S Haggerty Rd, Canton, MI 48188-2025 | 2019-09-08 |
| 1861966244 | Progressive Care Medical Group of Mi, Pllc | Clinic/Center | 734 Starkweather Drive, Lansing, MI 48917-1128 | 2019-01-18 |
| 1972006047 | Genise Kerner Md PC | Clinic/Center | 37675 Pembrooke Ave, Livonia, MI 48152 | 2018-03-14 |
| Find all providers with the same taxonomy | ||||
| City | PRUDENVILLE |
| Zip Code | 48651 |
Please comment or provide details below to improve the information on EAST BAY MEDICAL CENTER, P.C..
| 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.