# MICHIGAN MEDICAL PATIENT CARE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MICHIGAN MEDICAL PATIENT CARE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124290341
- **Legal business name:** MICHIGAN MEDICAL PATIENT CARE
- **Authorized official:** SCOTT HARRING (CFO)
- **Authorized official phone:** (616) 974-4889

## Contact information

- **Practice address:** 4069 LAKE DR SE, GRAND RAPIDS, MI 49546-8816
- **Practice address phone:** (616) 974-4800
- **Mailing address:** 4085 BURTON ST SE, SUITE 200, GRAND RAPIDS, MI 49546-2444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | — |
| 207W00000X | Ophthalmology Physician | — | — | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | NULL | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | — | — |
| 207Y00000X | Otolaryngology Physician | — | NULL | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | — |
| 2086S0129X | Vascular Surgery Physician | — | — | — |
| 2086X0206X | Surgical Oncology Physician | — | NULL | — |
| 2086X0206X | Surgical Oncology Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | NULL | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | — | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | — |
| 261QR0206X | Mammography Clinic/Center | — | NULL | — |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |

## Other

- **Enumeration date:** 03/27/2008
- **Last updated:** 03/02/2010