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NPI Code Detail

MEDICARE: DR. ETHAN AVERY BACHERT MD

MEDICARE: DR. ETHAN AVERY BACHERT MD
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 Physician4351056967MI

General Provider Information

NPI Number : 1720919376
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ETHAN AVERY BACHERT MD
Provider Business Mailing Address
First Line : 1675 LEAHY ST STE 315A
Second Line :
City : MUSKEGON
State : MI
Zip : 49442-5543
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1500 E SHERMAN BLVD
Second Line :
City : MUSKEGON
State : MI
Zip : 49444-1849
Country : US
Telephone Number : 231-672-3916
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2026
Last Update Date : 05/25/2026

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Directions to “ DR. ETHAN AVERY BACHERT MD” Practice Location

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