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General NPI Number Information
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NPI Number | 1508378027
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Entity Type | Organization
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Legal Business Name | ANESTHESIA ASSOCIATES OF GRAND RAPIDS, PLLC
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Dates
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Enumeration Date | 10/25/2017
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Last Update Date | 10/25/2017
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Provider Practice Location Address
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Address Line | 200 JEFFERSON AVE., SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503
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Country | US
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Telephone | 616-685-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 2006 HOGBACK RD STE 5A
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City | ANN ARBOR
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State | MI
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Zip | 48105
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Country | US
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Telephone | 734-263-2395
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Fax | 734-773-3471
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Authorized Official
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Title or Position | CEO
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Name | MR. JOE HYMES
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Credential |
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Telephone | 734-263-2390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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