NPIMap

Organization Active NPI

General and Internal Medicine

  • Clinic/Center
  • Prudenville, MI
National Provider Identifier
1376700294
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
4301403219 Issued in MI
Legal business name
GENERAL AND INTERNAL MEDICINE
Practice address
1064 W West Branch Rd
Prudenville, MI 48651-9468
Phone
(989) 366-4800
NPI assigned
May 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Marvin McElroyNPI 1053381871
Title
Owner
Phone
(989) 366-4800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 4301403219 MI Primary

Addresses

Primary practice location

1064 W West Branch Rd
Prudenville, MI 48651-9468

Mailing address

PO Box 268
Prudenville, MI 48651-0268
Phone (989) 366-4800

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1376700294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268",
            "city": "PRUDENVILLE",
            "state": "MI",
            "postal_code": "486510268",
            "telephone_number": "989-366-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 W WEST BRANCH RD",
            "city": "PRUDENVILLE",
            "state": "MI",
            "postal_code": "486519468",
            "telephone_number": "989-366-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL AND INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "MCELROY",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-366-4800",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "4301403219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prudenville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.