Healthcare Provider Details

I. General information

NPI: 1215906219
Provider Name (Legal Business Name): METROPOLITAN ANESTHESIA ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 BOSTON ST SE METROPOLITAN HOSPITAL
GRAND RAPIDS MI
49506-4160
US

IV. Provider business mailing address

96 MONROE CTR NW SUITE 300
GRAND RAPIDS MI
49503-2905
US

V. Phone/Fax

Practice location:
  • Phone: 616-808-3944
  • Fax: 616-808-3948
Mailing address:
  • Phone: 616-235-4800
  • Fax: 616-235-1212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. TIM VANLAAN
Title or Position: ACCOUNTANT
Credential:
Phone: 616-235-4800