Basic Information
| Provider Information | |||||||||
| NPI: | 1831140409 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AMELON | ||||||||
| FirstName: | MITZI | ||||||||
| MiddleName: | COLLEEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1447 N HARRISON ST | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486024727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9895834114 | ||||||||
| FaxNumber: | 9895831349 | ||||||||
| Practice Location | |||||||||
| Address1: | 2919 WILDER RD STE 150 | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 487069602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9896715757 | ||||||||
| FaxNumber: | 9896715775 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 11/10/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 5101010674 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.