Healthcare Provider Details

I. General information

NPI: 1396804571
Provider Name (Legal Business Name): GRAND RAPIDS ASSOCIATED INTERNISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 WEALTHY ST SE SUITE 375
GRAND RAPIDS MI
49506-2969
US

IV. Provider business mailing address

1900 WEALTHY ST SE SUITE 375
GRAND RAPIDS MI
49506-2969
US

V. Phone/Fax

Practice location:
  • Phone: 616-459-0292
  • Fax: 616-459-3922
Mailing address:
  • Phone: 616-459-0292
  • Fax: 616-459-3922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: LORI KROPEWNICKI
Title or Position: PRACTICE MANAGER
Credential:
Phone: 616-459-0292