Healthcare Provider Details

I. General information

NPI: 1487101945
Provider Name (Legal Business Name): TYLER THOMAS BILDEN MD, PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 04/19/2025
Certification Date: 04/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 MICHIGAN ST NE FL 9
GRAND RAPIDS MI
49503-2531
US

IV. Provider business mailing address

275 MICHIGAN ST NE FL 9
GRAND RAPIDS MI
49503-2531
US

V. Phone/Fax

Practice location:
  • Phone: 616-391-6243
  • Fax:
Mailing address:
  • Phone: 616-391-6243
  • Fax: 616-391-8612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0021483
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4351048258
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: