Healthcare Provider Details
I. General information
NPI: 1699572453
Provider Name (Legal Business Name): UNITED EXAMINATION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/28/2025
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 BURTON ST SE STE G
GRAND RAPIDS MI
49506-4670
US
IV. Provider business mailing address
5311 S PINE SLOPE CT SW
WYOMING MI
49519-9642
US
V. Phone/Fax
- Phone: 517-420-8736
- Fax:
- Phone: 517-420-8736
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EMILY
GERARDY
Title or Position: OWNER
Credential: PA-C
Phone: 517-420-8736