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General NPI Number Information
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NPI Number | 1891782728
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Entity Type | Organization
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Legal Business Name | MICHAEL G. MARCOTTE, M.D., P.C.
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 2060 43RD ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-5099
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Country | US
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Telephone | 616-281-0093
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Fax | 616-281-0580
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Provider Business Mailing Address
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Address Line | 2060 43RD ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-5099
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Country | US
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Telephone | 616-281-0093
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Fax | 616-281-0580
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL G. MARCOTTE
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Credential | M.D.
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Telephone | 616-281-0093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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