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General NPI Number Information
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NPI Number | 1487832853
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Entity Type | Organization
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Legal Business Name | KEVIN P PURGIEL DO PC
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 9385 CHERRY VALLEY AVE SE
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City | CALEDONIA
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State | MI
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Zip | 49316-8421
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Country | US
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Telephone | 616-891-8500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3140
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City | GRAND RAPIDS
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State | MI
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Zip | 49501-3140
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Country | US
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Telephone | 616-891-8500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEVIN PATRICK PURGIEL
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Credential | D.O.
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Telephone | 616-891-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 5101015467
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License Number State | MI
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