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General NPI Number Information
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NPI Number | 1265645824
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Entity Type | Organization
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Legal Business Name | METROPOLITAN INTERNISTS OF WEST MI
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1945 BOSTON ST SE G2
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-4100
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Country | US
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Telephone | 616-452-3399
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Fax | 616-452-9066
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Provider Business Mailing Address
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Address Line | 1945 BOSTON ST SE G2
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-4100
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Country | US
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Telephone | 616-452-3399
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Fax | 616-452-9066
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT F GLEFFE
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Credential | DO
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Telephone | 616-452-3399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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