Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blue Water Primary Care

Organization Family Medicine Physician · NPI 1013896638

Blue Water Primary Care is a Family Medicine Physician in Fort Gratiot, Michigan. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

3953 24th Ave
Fort Gratiot, MI 48059-4193
Phone: (734) 299-0712
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1013896638
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ibrahim Dabaja — Chief Operating Officer · (810) 363-9337
NPI enumeratedAugust 28, 2025
Last updated in NPPESJanuary 28, 2026
Certification dateJanuary 28, 2026
Mailing address3953 24th Ave, Fort Gratiot, MI 48059-4193

Other providers in Fort Gratiot