Healthcare Provider Details

I. General information

NPI: 1871533794
Provider Name (Legal Business Name): DONALD H KUIPER
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 W SAGINAW ST
LANSING MI
48915-1927
US

IV. Provider business mailing address

1701 LAKE LANSING RD SUITE 100
LANSING MI
48912-3798
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-7490
  • Fax:
Mailing address:
  • Phone: 517-485-0001
  • Fax: 517-485-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberDK026422
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: