# B KENT MAUPIN MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386651487
- **Authorized official:** BERNARD KENT MAUPIN M.D. (OWNER/PRESIDENT)
- **Authorized official phone:** (616) 954-0094

## Contact information

- **Practice address:** 1001 MEDICAL PARK DR SE, SUITE 211, GRAND RAPIDS, MI 49546-3610
- **Practice address phone:** (616) 954-0094
- **Practice address fax:** (616) 954-9871
- **Mailing address:** 1001 MEDICAL PARK DR SE, SUITE 211, GRAND RAPIDS, MI 49546-3610
- **Mailing address phone:** (616) 954-0094
- **Mailing address fax:** (616) 954-9871

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207XS0106X | Orthopaedic Hand Surgery Physician | 4301043303 | MI | Yes |

## Other

- **Enumeration date:** 08/02/2006
- **Last updated:** 08/22/2020