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Contact Information

PROFESSIONAL CORPORATION
LBN NORTHWEST MICHIGAN SURGICAL GROUP, P.C.
1221 SIXTH STREET
STE. 208
TRAVERSE CITY, MI49684
 Phone: 231-935-2844
 Fax: 231-935-2850
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for PROFESSIONAL CORPORATION

NPI Number 1386659043
LBN Legal business name NORTHWEST MICHIGAN SURGICAL GROUP, P.C.
DBA Doing business as PROFESSIONAL CORPORATION
Authorized official JAMES MCDONNELL - (PRESIDENT/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/30/2006
Last updated 03/17/2009 - About 11 years ago
Identifiers
MI License # JM008369
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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