Healthcare Provider Details

I. General information

NPI: 1487622296
Provider Name (Legal Business Name): INFUSION ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 EAGLE PARK DR NE SUITE 101
GRAND RAPIDS MI
49525-7007
US

IV. Provider business mailing address

1726 COLE BLVD STE 250
LAKEWOOD CO
80401-3262
US

V. Phone/Fax

Practice location:
  • Phone: 616-954-0600
  • Fax:
Mailing address:
  • Phone: 855-478-1528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL MAWBY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 616-954-0600