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

Southern Grand Traverse Medical

Organization Medical Physician Assistant · NPI 1851580815

Southern Grand Traverse Medical is a Medical Physician Assistant in Traverse City, Michigan. Licensed in Michigan. Registered with an NPI since 2007.

Licensed in
MI
In the registry since
2007

Practice location Address checks out

401 Munson Ave
Traverse City, MI 49686-3041
Phone: (231) 995-4902
Fax: (231) 932-7816
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 5601001376 (MI)

Record details

NPI number1851580815
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gary Schaub — Owner · (231) 995-4902
NPI enumeratedOctober 16, 2007
Last updated in NPPESOctober 16, 2007
Mailing address401 Munson Ave, Traverse City, MI 49686-3041

Other providers in Traverse City