Portage Physician Practices INC
Clinic/Center, Rural Health in Calumet, MI. Organization (NPI-2).
NPI number1164106910
StatusActive
Last updated in NPPESOct 12, 2023
Details
- NPI
- 1164106910
- Entity type
- Organization (NPI-2)
- Legal business name
- Portage Physician Practices INC
- Organization subpart
- No
- Enumeration date
- Jun 12, 2023
- Certification date
- Oct 12, 2023
- Last updated
- Oct 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | – | – | Yes |
Other names
- Up Medical Group - Portage Express Care (Doing Business As)
Practice location
56720 Calumet Ave Ste BCalumet, MI 49913-1967
Phone 906-481-8952 · Fax 906-337-4049
Mailing address
330 Seven Springs WayBrentwood, TN 37027-5098
Phone 615-920-7000
Authorized official
Monica Bowman
President
6159207000
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