SAULT OTOLARYNGOLOGY & FACIAL PLASTIC SURGERY PC (NPI# 1699028613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699028613 |
| Entity Type | Organization |
| Organization Name | SAULT OTOLARYNGOLOGY & FACIAL PLASTIC SURGERY PC |
| Practice Address |
333 Magazine St Ste 101 Sault Sainte Marie MI 49783-1867 |
| Practice Telephone | 9062590244 |
| Practice Fax Number | 9062590247 |
| Mailing Telephone | 9062590244 |
| Mailing Fax Number | 9062590247 |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2012-10-16 |
| Authorized Official Name | MARK A WALLACE (PRESIDENT) |
| Authorized Official Telephone | 8089377037 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
5101015234 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
333 MAGAZINE ST STE 101 |
| City | SAULT SAINTE MARIE |
| State | MI |
| Zip Code | 49783-1867 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669427753 | Paula M. Rechner | Specialist | 333 Magazine St, Ste #101, Sault Sainte Marie, MI 49783-1867 | 2006-05-24 |
| 1336746262 | Chippewa County War Memorial Hospital Inc | Family Medicine | 333 Magazine St, Sault Sainte Marie, MI 49783-1867 | 2020-10-05 |
| 1487034963 | Jessie Anne Skog | Audiologist | 333 Magazine St, Suite #3, Sault Sainte Marie, MI 49783-1867 | 2015-06-01 |
| 1316298326 | Jeffrey R Peterman Md PC | Respite Care | 333 Magazine St, Suite 102, Sault Sainte Marie, MI 49783-1867 | 2012-10-01 |
| 1225346281 | Timothy Oconnor Md PC | Respite Care | 333 Magazine St, Ste 102, Sault Sainte Marie, MI 49783-1867 | 2010-09-23 |
| 1952585382 | Paula Rechner Md, PC | Specialist | 333 Magazine St, Suite 101, Sault Sainte Marie, MI 49783-1867 | 2007-12-20 |
| 1255514766 | Joseph M. Garlinghouse Md PC | Family Medicine | 333 Magazine St, Suite 102, Sault Sainte Marie, MI 49783-1867 | 2007-12-07 |
| 1588851091 | Alpine Medical Supply & Rehab | Prosthetic/Orthotic Supplier | 333 Magazine St, Ste 103, Sault Sainte Marie, MI 49783-1867 | 2007-09-28 |
| 1952591828 | Mark Allen Wallace | Otolaryngology | 333 Magazine St, Suite 101, Sault Sainte Marie, MI 49783-1867 | 2007-07-27 |
| 1184712432 | Jeffrey Peterman | Family Medicine | 333 Magazine St, Suite 102, Sault Sainte Marie, MI 49783-1867 | 2006-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215541305 | Kevin P Cooper Dds PC | Dentist | 202 Brady Street, Sault Sainte Marie, MI 49783 | 2020-09-04 |
| 1033767512 | Louis William Bergman | Pharmacist | 3763 75 Business Spur, Sault Ste Marie, MI 49783 | 2019-08-28 |
| 1972076818 | Phyllis Mary Robertson | Speech-Language Pathologist | 2472 Ashmun Street, War Memorial Hospital Rehabilitation Centre, Sault Sainte Marie, MI 49783 | 2019-01-03 |
| 1831611748 | Thomas Matthew Choponis | Optometrist | 128 W Spruce St Ste 1, Sault Sainte Marie, MI 49783 | 2017-07-12 |
| 1730633223 | Holly D Statt | Dental Hygienist | 905 Marquette Ave, Sault Sainte Marie, MI 49783 | 2016-08-12 |
| 1316306590 | Debra Joyce Peake | Social Worker | 3865 South Mackinac Trail, Sault Ste Marie, MI 49783 | 2016-02-17 |
| 1629465935 | Jodi Johnson | Occupational Therapy Assistant | 1011 Merridian St, Sault Saint Marie, MI 49783 | 2015-04-24 |
| 1972885606 | Elizabeth Hayes | Social Worker | 3865 S Mackinac Trail, Sault Ste Marie, MI 49783 | 2011-09-20 |
| 1922252618 | Denise L. Montgomery | Registered Nurse | 500 Osborn Blvd., Sault Ste Marie, MI 49783 | 2008-11-08 |
| 1487829826 | Melanie A Cook | Eyewear Supplier (Equipment, not the service) | 1908 Ashman Street, Sault Ste Marie, MI 49783 | 2008-04-28 |
| Find all providers in zip 49783 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952591828 | Mark Allen Wallace | Otolaryngology | 333 Magazine St, Suite 101, Sault Sainte Marie, MI 49783-1867 | 2007-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851720312 | Prasad J Thottam | Otolaryngology | 7001 Ochard Lake Road, 320c, West Bloomfield, MI 48322-3607 | 2013-11-05 |
| 1932549375 | Alexander Peter Bill | Otolaryngology | 22631 Greater Mack Ave Ste 200, Saint Clair Shores, MI 48080 | 2013-06-30 |
| 1336362722 | Danny Kewson M.d. P.c | Otolaryngology | 2454 Monroe St Ste A, Dearborn, MI 48124 | 2007-04-11 |
| 1528145935 | Demello Medical Clinic | Otolaryngology | 39379 Garfield Rd, Cilnton Township, MI 48038 | 2006-11-01 |
| 1508979436 | Russell Wayne Craig | Otolaryngology | 17901 Hall Rd, Macomb Twp, MI 48044 | 2006-08-16 |
| 1942218177 | Paul E Lomeo | Otolaryngology | 268 W Seminole Rd, Muskegon, MI 49444-3733 | 2006-08-03 |
| 1891715991 | Phillips H Winter | Otolaryngology | 577 Michigan Avenue, Suite 101, Holland, MI 49423 | 2006-07-20 |
| 1336191139 | Robert Louis Borenitsch | Otolaryngology | 5200 State St, Saginaw, MI 48603-3713 | 2006-05-17 |
| 1124007539 | Ted H Schwartzenfeld | Otolaryngology | 27483 Dequindre Rd Ste 201, Madison Heights, MI 48071-5711 | 2006-01-13 |
| 1851390066 | Michael Andrew Freedman | Otolaryngology | 14600 King Rd Ste D, Riverview, MI 48193-7952 | 2005-07-19 |
| Find all providers with the same taxonomy | ||||
| City | SAULT SAINTE MARIE |
| Zip Code | 49783 |
Please comment or provide details below to improve the information on SAULT OTOLARYNGOLOGY & FACIAL PLASTIC SURGERY PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.