# 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:** 1700058492
- **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, GRAND RAPIDS, MI 49546-8292
- **Practice address phone:** (616) 974-4889
- **Mailing address:** 4085 BURTON ST SE, SUITE 200, GRAND RAPIDS, MI 49546-2444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RB0002X | Obesity Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RB0002X | Obesity Medicine (Internal Medicine) Physician | — | — | — |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RG0100X | Gastroenterology Physician | — | NULL | — |
| 207RG0100X | Gastroenterology Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | — | — |
| 2080P0202X | Pediatric Cardiology Physician | — | NULL | — |
| 2080P0202X | Pediatric Cardiology Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | NULL | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | — | — |
| 261QR0200X | Radiology Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 04/02/2008
- **Last updated:** 03/02/2010