# 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:** 1396801767
- **Legal business name:** MICHIGAN MEDICAL PATIENT CARE
- **Authorized official:** SCOTT HARRING (CFO)
- **Authorized official phone:** (616) 974-4889

## Contact information

- **Practice address:** 4100 LAKE DR SE, SUITE 300, GRAND RAPIDS, MI 49546-8292
- **Practice address phone:** (616) 974-4889
- **Mailing address:** 4085 BURTON ST SE, SUITE 200, GRAND RAPIDS, MI 49546-2444
- **Mailing address phone:** (616) 974-4889

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/29/2006
- **Last updated:** 03/02/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 500D116710 | BCBS PIN | MI |