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General NPI Number Information
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NPI Number | 1588629703
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Entity Type | Individual
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Provider Name | MIRIAM BENEDICTA VOS MD, MSPH
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Gender | Female
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 35 MICHIGAN ST NE STE 4150
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2529
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Country | US
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Telephone | 616-267-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 959 PINECREST AVE SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-3436
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Country | US
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Telephone | 404-803-7733
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 54160
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License Number State | GA
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