NPI 1114512092

Jordan Bellmore, PAC

Practitioner Physician Assistant Alpena, MI

Practice location

Address: 109 S 13th Ave, Alpena, MI 49707-1609
Phone: (989) 356-2400
Mailing address: 8775 Winding Ridge Dr, Millersburg, MI 49759

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 5601010435 (MI)

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Registry record

NPI: 1114512092
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Mar 2021
Record last updated: 3 Mar 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.