Healthcare Provider Details

I. General information

NPI: 1578254025
Provider Name (Legal Business Name): COURTNEY BELL HURD DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2023
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LAFAYETTE AVE SE STE 3000
GRAND RAPIDS MI
49503-4692
US

IV. Provider business mailing address

260 JEFFERSON AVE SE STE 305
GRAND RAPIDS MI
49503-4597
US

V. Phone/Fax

Practice location:
  • Phone: 616-685-6919
  • Fax:
Mailing address:
  • Phone: 616-685-4615
  • Fax: 616-685-3033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5151016056
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: