Healthcare Provider Details

I. General information

NPI: 1487813200
Provider Name (Legal Business Name): METROPOLITAN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5950 METRO WAY SW
WYOMING MI
49519
US

IV. Provider business mailing address

985 GEZON PKWY SW
WYOMING MI
49509-9563
US

V. Phone/Fax

Practice location:
  • Phone: 616-252-8100
  • Fax: 616-252-8181
Mailing address:
  • Phone: 616-252-4655
  • Fax: 616-252-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number410060
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number410060
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number410060
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number410060
License Number StateMI

VIII. Authorized Official

Name: MR. KRIS P KURTZ
Title or Position: CFO
Credential:
Phone: 616-252-4844