MEDICARE: DR. ANDREW P JAMESON 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
1	207R00000X	Internal Medicine Physician	4301090524	MI
2	207RI0200X	Infectious Disease Physician	4301090524	MI

General Provider Information

NPI Number	:	1770781890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW P JAMESON MD

Provider Business Mailing Address
First Line	:	310 LAFAYETTE AVE SE
Second Line	:	SUITE 410
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-4693
Country	:	US
Telephone Number	:	616-685-8200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 44TH ST SE
Second Line	:
City	:	KENTWOOD
State	:	MI
Zip	:	49508-5008
Country	:	US
Telephone Number	:	616-685-8500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2007
Last Update Date	:	04/13/2016

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