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

McLaren Bay Region

Organization Family Medicine Physician · NPI 1629357090

McLaren Bay Region is a Family Medicine Physician in Prudenville, Michigan. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
6

Practice location Address checks out

200 Grand Ave
Prudenville, MI 48651
Phone: (989) 366-1000
Fax: (989) 366-1002
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Physician Assistant Taxonomy 363A00000X
Family Nurse Practitioner Taxonomy 363LF0000X
Gerontology Nurse Practitioner Taxonomy 363LG0600X
Pediatric Nurse Practitioner Taxonomy 363LP0200X

Record details

NPI number1629357090
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Danielle Jacks Porter — Cfo · (989) 894-3838
NPI enumeratedAugust 16, 2011
Last updated in NPPESAugust 7, 2018
Mailing address200 Grand Ave, Po Box 679, Prudenville, MI 48651-9571

Other providers in Prudenville