Mahp standard practitioner application 2025

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The document is a Standard Practitioner Application created by the Michigan Association of Health Plans (MAHP) for practitioner credentialing. It outlines the necessary personal, professional, and practice-related information required from healthcare practitioners seeking affiliation with health plans. The application includes sections for personal details, practice specialty, office information, medical education, work history, licensure, board certification, references, professional liability insurance, claims history, health status disclosures, and attestation statements. It emphasizes the importance of accuracy and completeness in the provided information.

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