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General NPI Number Information
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NPI Number | 1770781890
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Entity Type | Individual
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Provider Name | ANDREW P JAMESON MD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 04/13/2016
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Provider Practice Location Address
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Address Line | 1900 44TH ST SE
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City | KENTWOOD
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State | MI
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Zip | 49508-5008
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Country | US
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Telephone | 616-685-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 310 LAFAYETTE AVE SE SUITE 410
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4693
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Country | US
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Telephone | 616-685-8200
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301090524
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 4301090524
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License Number State | MI
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