MEDICARE: WESTERN MICHIGAN HEARING SERVICES, INC.

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	231H00000X	Audiologist	1601000019	MI

General Provider Information

NPI Number	:	1689860546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN MICHIGAN HEARING SERVICES, INC.

Provider Business Mailing Address
First Line	:	4232 29TH ST SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49512-1936
Country	:	US
Telephone Number	:	616-942-1818
Fax Number	:	616-942-6567

Provider Business Practice Location Address
First Line	:	4232 29TH ST SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49512-1936
Country	:	US
Telephone Number	:	616-942-1818
Fax Number	:	616-942-6567

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EDWARD JOSEPH SZUMOWSKI
Credential	:	AU.D.
Telephone Number	:	616-942-1818

Provider Enumeration Date	:	09/24/2007
Last Update Date	:	09/24/2007

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