# MICHIGAN MEDICAL PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MICHIGAN MEDICAL PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1700052230
- **Legal business name:** MICHIGAN MEDICAL PC
- **Authorized official:** SCOTT HARRING (CFO)
- **Authorized official phone:** (616) 974-4889

## Contact information

- **Practice address:** 2093 HEALTH DR SW, GRAND RAPIDS, MI 49519-9691
- **Practice address phone:** (616) 459-8700
- **Mailing address:** 4085 BURTON ST SE, SUITE 200, GRAND RAPIDS, MI 49546-2444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/05/2008
- **Last updated:** 05/05/2008