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NPI Code Detail

MEDICARE: DIANA LYNN BITNER MD

MEDICARE: DIANA LYNN BITNER MD
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
1207V00000XObstetrics & Gynecology Physician4301060158MI

General Provider Information

NPI Number : 1457308488
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA LYNN BITNER MD
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE
Second Line : MC 845
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3800 LAKE MICHIGAN DR NW
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49534-4583
Country : US
Telephone Number : 616-267-8520
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 06/05/2018

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