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Organization
AGE MANAGEMENT OF WEST MICHIGAN PC
Active
Organization
AGE MANAGEMENT OF WEST MICHIGAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PIYUSH BHATNAGAR MD (CLINICAL MEDICAL DIRECTOR/OWNER)
(616) 808-2695
Entity
Organization
Contact information
Practice address
1959 E PARIS AVE SE, GRAND RAPIDS, MI 49546-6272
(616) 808-2695
Mailing address
1959 E PARIS AVE SE, GRAND RAPIDS, MI 49546-6272
(616) 808-2695
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/21/2013
Last updated
06/21/2013
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