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Contact Information

SEMINOLE SHORES INTERNAL MEDICINE PC
433 SEMINOLE RD
SUITE 105
MUSKEGON, MI49444-3743
 Phone: 231-739-2192
 Fax: 231-739-2343
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

207RS0010X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for SEMINOLE SHORES INTERNAL MEDICINE PC · (Female)

NPI # 1467631804
Status Active
Credentials
Entity Individual
Enumeration date 11/02/2007
Last updated 07/01/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • MI License # 4301062711
  • MI Medicaid 4559980
  • MI Other 1106110251 BLUE CROSS BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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