Healthcare Provider Details

I. General information

NPI: 1366459554
Provider Name (Legal Business Name): KENNETH W POST MD PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4070 LAKE DR SE
GRAND RAPIDS MI
49546-8294
US

IV. Provider business mailing address

4070 LAKE DR SE
GRAND RAPIDS MI
49546-8294
US

V. Phone/Fax

Practice location:
  • Phone: 616-954-1763
  • Fax: 616-954-1823
Mailing address:
  • Phone: 616-954-1763
  • Fax: 616-954-1823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: KENNETH WAYNE POST
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 616-954-1763