# ALLERGY & ASTHMA CENTERS OF WEST MICHIGAN, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Allergy/Asthma Specialists W. MI
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568632669
- **Authorized official:** VINCENT DUBRAVEC MD (PRESIDENT)
- **Authorized official phone:** (616) 988-8515

## Contact information

- **Practice address:** 5055 PLAINFIELD AVE NE, SUITE C, GRAND RAPIDS, MI 49525-1075
- **Practice address phone:** (616) 988-8515
- **Mailing address:** 5055 PLAINFIELD AVE NE, SUITE C, GRAND RAPIDS, MI 49525-1075
- **Mailing address phone:** (616) 988-8515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 4301073903 | MI | Yes |

## Other

- **Enumeration date:** 03/04/2008
- **Last updated:** 03/04/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4301073903 | STATE MEDICAL LICENSE | MI |
| 05 | — | 4395260 | — | MI |