PHYSICIAN HEALTHCARE NETWORK, PC
NPI 1750334405
Family Medicine in Marysville, MI

Q: What is Physician Healthcare Network, PC's NPI number?

The NPI number for Physician Healthcare Network, PC is 1750334405. It was assigned to this organization in the NPPES registry on May 17, 2006.

Q: What is Physician Healthcare Network, PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since May 17, 2006CLIA Certified · 2 labs

3350 GRATIOT BLVD, MARYSVILLE, MI 48040(810) 364-4000(810) 364-5995 Get Directions Write a Review

NPPES record last updated: February 25, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 19, 2022, Jul 21, 2022 (2 updates tracked since 2022).

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About Physician Healthcare Network, Pc NPPES

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

PHYSICIAN HEALTHCARE NETWORK, PC (NPI 1750334405) is a healthcare organization registered as a family medicine in Marysville, Michigan and active in the NPI registry since May 2006. The organization holds 2 active CLIA laboratory certificates, maintains 5 additional practice locations, and lists Mimma Cusumano, Director Of Finance, as its authorized official.

NPPES Registry Identity

NPI1750334405

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NamePHYSICIAN HEALTHCARE NETWORK, PC

Location Address3350 GRATIOT BLVDMarysville, MI 48040-2121

Mailing Address3050 Commerce Dr, Billing And AdministrationFort Gratiot, MI 48059-3819 · (810) 385-4441 · Fax (810) 385-1950

Phone(810) 364-4000

Fax(810) 364-5995

Organization SubpartNo

Authorized OfficialMimma CusumanoDirector Of Finance · (810) 385-8081

Enumeration DateMay 17, 2006

Last NPPES UpdateFebruary 25, 20262 updates tracked since enumeration

NPPES CertifiedFebruary 25, 2026

✔ NPI 1750334405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 11

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedInternal Medicine · GastroenterologyTaxonomy 207RG0100X

Also ListedPediatricsTaxonomy 208000000X

Also ListedSurgeryTaxonomy 208600000X

Also ListedGeneral PracticeTaxonomy 208D00000X

Also ListedPhysician AssistantTaxonomy 363A00000X

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X

Also ListedNurse PractitionerTaxonomy 363L00000X

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X

3350 GRATIOT BLVD, Marysville, MI 48040

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Secondary Practice Locations 5

Location 11231 Pine Grove Ave Ste 2APort Huron, MI 48060-3500 · Phone (810) 982-8742 · Fax (810) 984-8291

Location 24190 24th AveFort Gratiot, MI 48059-3882 · Phone (810) 989-7788 · Fax (810) 989-7799

Location 336267 26 Mile Rd Ste 3Lenox, MI 48048-3253 · Phone (586) 716-1371 · Fax (586) 716-4855

Location 44190 24th Ave Ste 204Fort Gratiot, MI 48059-3884 · Phone (810) 216-1000 · Fax (810) 216-3138

Location 52425 Military St Bldg 2Port Huron, MI 48060-6692 · Phone (810) 984-5700 · Fax (810) 984-1886

Other Identifiers 1

Medicaid1750334405MI

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D0935908

Physician Healthcare Network · Port Huron, MI

Active · expires May 21, 2028

CLIA Number23D0935908

Laboratory TypePhysician Office

Certificate Effective DateMay 22, 2026

Certificate Expiration DateMay 21, 2028

Laboratory DirectorKavita M. Tumma

Laboratory Phone(810) 982-8742

Laboratory LocationPhysician Healthcare Network1231 Pine Grove Avenue Suite 2A, Port Huron, MI 48060

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D2211876

Physician Healthcare Network Pediatrics · Fort Gratiot, MI

Active · expires Jan 31, 2027

CLIA Number23D2211876

Laboratory TypePhysician Office

Certificate Effective DateFebruary 1, 2025

Certificate Expiration DateJanuary 31, 2027

Laboratory DirectorDaniel Souphis

Laboratory Phone(810) 216-1000

Laboratory LocationPhysician Healthcare Network Pediatrics4190 24th Avenue Suite 204, Fort Gratiot, MI 48059

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEGHAN KINTER PA-C

Physician Assistant (Medical)