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NPI Code Detail

MEDICARE: DANIEL OVERBEEK M.D.

MEDICARE: DANIEL OVERBEEK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician1336529585MI
2207PT0002XMedical Toxicology (Emergency Medicine) Physician1336529585MI
3207L00000XAnesthesiology Physician4301107451MI

General Provider Information

NPI Number : 1336529585
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL OVERBEEK M.D.
Provider Business Mailing Address
First Line : 4100 EMBASSY DR SE STE 400
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49546-2416
Country : US
Telephone Number : 616-975-1845
Fax Number :
Provider Business Practice Location Address
First Line : 1840 WEALTHY ST SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49506-2921
Country : US
Telephone Number : 616-391-1774
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2015
Last Update Date : 02/24/2025

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