Healthcare Provider Details

I. General information

NPI: 1124388269
Provider Name (Legal Business Name): ANNA LISA ALPEROVICH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 MICHIGAN ST NE STE 2200
GRAND RAPIDS MI
49503-2562
US

IV. Provider business mailing address

1 GUSTAVE L LEVY PL BOX 3000
NEW YORK NY
10029-6504
US

V. Phone/Fax

Practice location:
  • Phone: 616-486-5933
  • Fax:
Mailing address:
  • Phone: 212-987-3100
  • Fax: 212-731-5210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number280809
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: