Healthcare Provider Details

I. General information

NPI: 1972000156
Provider Name (Legal Business Name): PAIGE CATHERINE GOOTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTER FOR BREAST & BODY CONTOURING PC 4070 LAKE DRIVE SE SUITE 202
GRAND RAPIDS MI
49546
US

IV. Provider business mailing address

CENTER FOR BREAST & BODY CONTOURING PC 4070 LAKE DRIVE SE SUITE 202
GRAND RAPIDS MI
49546
US

V. Phone/Fax

Practice location:
  • Phone: 616-464-4420
  • Fax: 616-464-4354
Mailing address:
  • Phone: 616-464-4420
  • Fax: 616-464-4354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number4301514917
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: