# GRAND VALLEY MEDICAL SPECIALISTS PLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grand Valley Internal Medicine Specialists, PLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033226402
- **Authorized official:** JOANNE REYNOLDS (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (616) 235-4800

## Contact information

- **Practice address:** 1000 EAST PARIS AVE SE STE 100, GRAND RAPIDS, MI 49546-3680
- **Practice address phone:** (616) 459-3158
- **Practice address fax:** (616) 742-6758
- **Mailing address:** 1000 EAST PARIS AVE SE STE 100, GRAND RAPIDS, MI 49546-3680
- **Mailing address phone:** (616) 459-3158
- **Mailing address fax:** (616) 742-6758

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RG0100X | Gastroenterology Physician | — | NULL | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |

## Other

- **Enumeration date:** 08/23/2006
- **Last updated:** 11/06/2023