MEDICARE: EMERGENCY CARE SPECIALISTS PC

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
1	282NC0060X	Critical Access Hospital	5601004845	MI

General Provider Information

NPI Number	:	1497820526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMERGENCY CARE SPECIALISTS PC

Provider Business Mailing Address
First Line	:	440 CRESCENT ST NE APT 5
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-3370
Country	:	US
Telephone Number	:	269-998-5992
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 EMBASSY DR SE STE 201
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-2416
Country	:	US
Telephone Number	:	616-988-8220
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RALPH ROGERS
Credential	:	M.D.
Telephone Number	:	616-988-8221

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	08/22/2020

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