Healthcare Provider Details

I. General information

NPI: 1477913242
Provider Name (Legal Business Name): DIALYSIS ACCESS PARTNERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2016
Last Update Date: 03/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 S CRAPO ST SUITE F
MT PLEASANT MI
48858-2961
US

IV. Provider business mailing address

211 S CRAPO ST SUITE F
MT PLEASANT MI
48858-2961
US

V. Phone/Fax

Practice location:
  • Phone: 989-773-2081
  • Fax: 989-773-3418
Mailing address:
  • Phone: 989-773-2081
  • Fax: 989-773-3418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JOHANNES BUITEWEG
Title or Position: PRESIDENT
Credential: MD
Phone: 989-773-2081