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NPI Code Detail

MEDICARE: THOMAS R. ARENDSHORST MD

MEDICARE: THOMAS R. ARENDSHORST 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
1207W00000XOphthalmology Physician4301037566MI

General Provider Information

NPI Number : 1902009368
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS R. ARENDSHORST MD
Provider Business Mailing Address
First Line : 4085 BURTON ST SE
Second Line : SUITE 200
City : GRAND RAPIDS
State : MI
Zip : 49546-2444
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 336 S RIVER AVE
Second Line :
City : HOLLAND
State : MI
Zip : 49423-3326
Country : US
Telephone Number : 616-394-3788
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2007
Last Update Date : 07/08/2007

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Directions to “ THOMAS R. ARENDSHORST MD” Practice Location

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