# BEAUMONT MEDICAL GROUP- SPECIALTY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Corewell Health Medical Group East Specialty Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083415640
- **Authorized official:** MATTHEW E COX (CFO)
- **Authorized official phone:** (616) 295-4264

## Contact information

- **Practice address:** 17000 KERCHEVAL AVE, GROSSE POINTE, MI 48230-1570
- **Practice address phone:** (313) 640-2424
- **Mailing address:** 100 MICHIGAN ST NE \# MC845, GRAND RAPIDS, MI 49503-2560

## Taxonomy

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

## Other

- **Enumeration date:** 03/20/2025
- **Last updated:** 03/20/2025