MHSN Roscommon Mpca – Family Medicine Physician

Key facts

NPI: 1376597807
Entity type: Organization (NPI type 2)
Primary specialty: Family Medicine Physician 207Q00000X
Legal business name: MHSN ROSCOMMON MPCA
Practice address: 234 Lake St
Roscommon, MI 48653-9203
Phone: (989) 275-1200
NPI assigned: May 20, 2006
Organization subpart: No

Authorized official

Name: Stephanie Riemer
Title: Chief Executive Officer
Phone: (989) 348-5461

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

MHSN Primary Care Services Family Medicine Physician · Prudenville, MI · NPI 1578516498

NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Douglas Harley Slater, MD Pediatrics Physician · Grayling, MI · NPI 1134152382

NPD (past) INTERNAL MEDICINE

National Provider Directory

Tax ID family: Mercy Hospital Grayling (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)	Code	Primary
Clinical Psychologist Group: 193200000X MULTI-SPECIALTY GROUP	103TC0700X
Family Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	207Q00000X	Yes
Internal Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	207R00000X
Pediatrics Physician Group: 193200000X MULTI-SPECIALTY GROUP	208000000X
Rural Health Clinic/Center	261QR1300X

Addresses

Primary practice location

234 Lake St
Roscommon, MI 48653-9203

Mailing address

PO Box 647
Grayling, MI 49738-0647
Phone (989) 348-1040

Other identifiers

Identifier	Type	State	Issuer
OG21003	Other	MI	BC/BS MICHIGAN

Other providers in Roscommon, MI

All providers in Roscommon, MI · Family Medicine Physician in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.