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General NPI Number Information
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NPI Number | 1114920550
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Entity Type | Organization
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Legal Business Name | EMERGENCY PHYSICIANS INC PC
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 08/21/2007
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Provider Practice Location Address
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Address Line | 300 68TH ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49548-6927
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Country | US
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Telephone | 616-455-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 300 68TH ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49548-6927
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Country | US
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Telephone | 616-455-5000
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Fax |
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Authorized Official
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Title or Position | HEAD OF GROUP
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Name | JOHN A RUPKE
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Credential | MD
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Telephone | 616-242-4334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4301026158
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License Number State | MI
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