Healthcare Provider Details

I. General information

NPI: 1477476562
Provider Name (Legal Business Name): JAMES BIRMINGHAM MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6741 FULTON ST E
ADA MI
49301-9502
US

IV. Provider business mailing address

6741 FULTON ST E
ADA MI
49301-9502
US

V. Phone/Fax

Practice location:
  • Phone: 616-320-5330
  • Fax: 616-320-5331
Mailing address:
  • Phone: 616-320-5330
  • Fax: 616-320-5331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: JAMES BIRMINGHAM
Title or Position: OWNER
Credential: MD
Phone: 616-320-5330