Central Michigan University

Organization Sports Medicine (Family Medicine) Physician · NPI 1447606801

Central Michigan University is a Sports Medicine (Family Medicine) Physician in Mt Pleasant, Michigan. Licensed in Michigan. Registered with an NPI since 2016.

Licensed in: MI
In the registry since: 2016

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Practice location Partly verified

Some contact details are missing from the federal record.

Cmu Sports Medicine Rose 100
Mt Pleasant, MI 48859-0001
Phone: (989) 774-2281
Fax: (989) 774-1095

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Specialties & licences

Sports Medicine (Family Medicine) Physician (primary)	Taxonomy 207QS0010X · Licence 5101018472 (MI)

Record details

NPI number	1447606801
Entity type	Organization (Type 2)
Organization subpart	Yes
Parent organization	1588897896
Authorized official	Matthew Jackson — Athletic Director · (989) 774-7657
NPI enumerated	May 4, 2016
Last updated in NPPES	May 27, 2016
Mailing address	Cmu Sports Medicine, Rose 100, Mt Pleasant, MI 48859-0001