Healthcare Provider Details

I. General information

NPI: 1013166222
Provider Name (Legal Business Name): MIDWEST INSTITUTE OF HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2008
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 E PARIS AVE SE SUITE 100
GRAND RAPIDS MI
49546-6113
US

IV. Provider business mailing address

2060 E PARIS AVE SE SUITE 100
GRAND RAPIDS MI
49546-6113
US

V. Phone/Fax

Practice location:
  • Phone: 616-956-6100
  • Fax: 616-956-6637
Mailing address:
  • Phone: 616-956-6100
  • Fax: 616-956-6637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberPK068077
License Number StateMI

VIII. Authorized Official

Name: MRS. TIFFANY RENEE SHEELY
Title or Position: PRACTICE MANAGER
Credential:
Phone: 616-956-6100