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NPI Code Detail

MEDICARE: MICHIGAN MEDICAL PATIENT CARE

MEDICARE: MICHIGAN MEDICAL PATIENT CARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086S0129XVascular Surgery Physician
2207RP1001XPulmonary Disease Physician

General Provider Information

NPI Number : 1275700262
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHIGAN MEDICAL PATIENT CARE
Provider Business Mailing Address
First Line : 4085 BURTON ST SE
Second Line : SUITE 200
City : GRAND RAPIDS
State : MI
Zip : 49546-2444
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 301 N MAIN ST
Second Line :
City : SHERIDAN
State : MI
Zip : 48884-9235
Country : US
Telephone Number : 616-291-3261
Fax Number :
Authorized Official
Title or Position : CFO
Name : SCOTT HARRING
Credential :
Telephone Number : 616-974-4889
Provider Enumeration Date : 05/09/2008
Last Update Date : 03/02/2010

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Directions to “MICHIGAN MEDICAL PATIENT CARE ” Practice Location

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