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General NPI Number Information
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NPI Number | 1548334576
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Entity Type | Individual
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Provider Name | DONALD J SCHOLTEN MD
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 01/31/2011
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Provider Practice Location Address
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Address Line | 4069 LAKE DR SE SUITE 117
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-8816
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Country | US
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Telephone | 616-459-4601
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Fax | 616-459-0200
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Provider Business Mailing Address
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Address Line | 100 MICHIGAN ST NE MC845
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2560
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DS039516
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License Number State | MI
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