BLUE WATER MEDICAL PLLC
NPI 1336409192
Clinic/Center in Port Huron, MI

Q: What is Blue Water Medical PLLC's NPI number?

The NPI number for Blue Water Medical PLLC is 1336409192. It was assigned to this organization in the NPPES registry on May 25, 2012.

Q: What is Blue Water Medical PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since May 25, 2012

511 FORT ST, SUITE 102, PORT HURON, MI 48060(810) 479-4769(888) 414-4545 Get Directions Write a Review

NPPES record last updated: May 25, 2012. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Blue Water Medical Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUE WATER MEDICAL PLLC (NPI 1336409192) is a healthcare organization registered as a clinic/center in Port Huron, Michigan and active in the NPI registry since May 2012. The organization lists Marcus K. Free, President/member, as its authorized official.

NPPES Registry Identity

NPI1336409192

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameBLUE WATER MEDICAL PLLC

Location Address511 FORT ST, SUITE 102Port Huron, MI 48060-3922

Mailing Address511 Fort St, Suite 102Port Huron, MI 48060-3922 · (810) 479-4769 · Fax (888) 414-4545

Phone(810) 479-4769

Fax(888) 414-4545

Organization SubpartNo

Authorized OfficialMarcus K. FreePresident/member · (810) 479-4769

Enumeration DateMay 25, 2012

✔ NPI 1336409192 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

License✔ Licensed in MI · 4301093347

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

511 FORT ST, Port Huron, MI 48060

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blue Water Medical PLLC's NPI number?

The NPI number for Blue Water Medical PLLC is 1336409192. It was assigned to this organization in the NPPES registry on May 25, 2012.

Where is Blue Water Medical PLLC located?

Blue Water Medical PLLC is located at 511 Fort St Suite 102, Port Huron, MI 48060. The listed phone number is (810) 479-4769.

What is Blue Water Medical PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Blue Water Medical PLLC was last updated on May 25, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.