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Organization
WYOMING FAMILY MEDICINE PC
Active
Organization
WYOMING FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA MAIDENS (BUSINESS MANAGER)
(616) 534-1640
Entity
Organization
Contact information
Practice address
950 36TH ST SW, WYOMING, MI 49509-3587
(616) 534-1640
(616) 534-4370
Mailing address
950 36TH ST SW, WYOMING, MI 49509-3587
(616) 534-1640
(616) 534-4370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D16011
BC/BSM GROUP PROVIDER
MI
Enumeration date
08/08/2006
Last updated
08/22/2020
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