Healthcare Provider Details

I. General information

NPI: 1215093216
Provider Name (Legal Business Name): ALGER PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 ALGER ST SE
GRAND RAPIDS MI
49507-3530
US

IV. Provider business mailing address

733 ALGER ST SE
GRAND RAPIDS MI
49507-3530
US

V. Phone/Fax

Practice location:
  • Phone: 616-243-9515
  • Fax: 616-243-1815
Mailing address:
  • Phone: 616-243-9515
  • Fax: 616-243-1815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number042824
License Number StateMI

VIII. Authorized Official

Name: DR. DOUGLAS BRIAN DAINING
Title or Position: PRESIDENT
Credential: MD
Phone: 616-243-9515