OrganizationTraverse Observation Physician Services PcEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address1105 6th St, Traverse City, MI 49684-2345(231) 947-0673PECOS EnrollmentBased on the most recent information from CMS, provider Traverse Observation Physician Services Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 11 days ago.Profile DetailsProvider ID1851671697Provider TypeOrganizationFull NameTraverse Observation Physician Services PcSubpartNoEnumeration Date8/25/2011Last Updated11/2/2011Contact InformationPractice LocationPractice Address1105 6th St, Traverse City, MI 49684-2345Phone(231) 947-0673FaxUnlisted FaxMailing LocationMailing Address4624 N Spider Lake Rd, Traverse City, MI 49696-8440Phone(231) 947-0673FaxUnlisted FaxAuthorized OfficialNameKaehler, Yvonne Evelyne (Business Manager)Phone(231) 947-0673Provider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID001DescriptionOtherIssuerPRIORITY HEALTHMichigan