Blue Water Internal Medicine, PC
NPI 1255967667ActiveOrganization· Internal Medicine· Port Huron, MI
Internal Medicine in Port Huron, Michigan, registered in NPPES in March 2020. The authorized official on file is Nikki Hack, Practice Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1255967667 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 17, 2020 |
| Last updated in NPPES | Nov 18, 2024 |
| Certified by provider | Nov 18, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MI) |
|---|
Other internal medicine physicians in Port Huron
- 1134176878
- 1265415285
- 1417941055
- 1538153176
- 1790825008
- 1154737609
- 1164620753
- 1285279919
- 1326230970
- 1366825986
- 1376846162
- 1427840586
All 19 internal medicine physicians in Port Huron · All internal medicine physicians in Michigan