BLUE CROSS AND BLUE SHIELD OF MICHIGAN PRACTITIONER TRADITIONAL PARTICIPATION AGREEMENTParticipation Agreement • May 19th, 2016 • Michigan
Contract Type FiledMay 19th, 2016 JurisdictionTHIS AGREEMENT is made by and between Blue Cross Blue Shield of Michigan, a Michigan nonprofit healthcare corporation, (“BCBSM”) and the undersigned Practitioner who is fully licensed or legally authorized to practice in the state of Michigan ("PRACTITIONER").