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SOUTHERN GRAND TRAVERSE MEDICAL
NPI 1851580815
Physician Assistant - Medical in Traverse City, MI

Active since October 16, 2007
401 MUNSON AVE, TRAVERSE CITY, MI 49686(231) 995-4902(231) 932-7816 Get Directions Write a Review

NPPES record last updated: October 16, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Southern Grand Traverse Medical NPPES

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

SOUTHERN GRAND TRAVERSE MEDICAL (NPI 1851580815) is a healthcare organization registered as a medical in Traverse City, Michigan and active in the NPI registry since October 2007. The organization lists Gary J Schaub, Owner, as its authorized official.

NPPES Registry Identity

NPI1851580815
Entity TypeOrganization
Primary Taxonomy363AM0700X
Legal Business NameSOUTHERN GRAND TRAVERSE MEDICAL
Location Address401 MUNSON AVETraverse City, MI 49686-3041
Mailing Address401 Munson AveTraverse City, MI 49686-3041 · (231) 995-4902 · Fax (231) 932-7816
Phone(231) 995-4902
Fax(231) 932-7816
Organization SubpartNo
Authorized OfficialGary J SchaubOwner · (231) 995-4902
Enumeration DateOctober 16, 2007
✔ NPI 1851580815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in MI · 5601001376
401 MUNSON AVE, Traverse City, MI 49686
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Other Identifiers 1

Medicare UPINS56391MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

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

BAYSIDE DOC'S URGENT CARE OFFICE
General Practice
401 MUNSON AVE
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 933-9150
BAYSIDE DOCS URGENT CARE PLC
Clinic/Center (Urgent Care)
401 MUNSON AVE
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 933-9150
DR. MICHAEL J PARKER MD
Emergency Medicine
401 MUNSON AVE
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 933-9150
LORENA REYES PTA
Physical Therapy Assistant
401 MUNSON AVE
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 944-6541
MRS. CAROL ANN STRAIGHT NP
Nurse Practitioner (Family)
401 MUNSON AVE
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 935-0500
GREAT LAKES ORTHOPAEDIC CENTER, P.C.
Orthopaedic Surgery
401 MUNSON AVE
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 935-0900

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 Southern Grand Traverse Medical's NPI number?

The NPI number for Southern Grand Traverse Medical is 1851580815. It was assigned to this organization in the NPPES registry on October 16, 2007.

Where is Southern Grand Traverse Medical located?

Southern Grand Traverse Medical is located at 401 Munson Ave, Traverse City, MI 49686. The listed phone number is (231) 995-4902.

What is Southern Grand Traverse Medical's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Southern Grand Traverse Medical was last updated on October 16, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.