Healthcare Provider Details

I. General information

NPI: 1144969239
Provider Name (Legal Business Name): ELIZABETH MARY GIAIMO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2022
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 BYRON CENTER AVE SW
WYOMING MI
49519-9606
US

IV. Provider business mailing address

3333 EVERGREEN DR NE
GRAND RAPIDS MI
49525-9493
US

V. Phone/Fax

Practice location:
  • Phone: 616-364-4200
  • Fax:
Mailing address:
  • Phone: 616-364-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number5101029309
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: