Organization
GASTROENTEROLOGY SPECIALIST PC
Active
Organization
GASTROENTEROLOGY SPECIALIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE J ATKINSON (MANAGER)
(616) 975-9100
Entity
Organization
Contact information
Practice address
1179 E PARIS AVE SE STE 200, GRAND RAPIDS, MI 49546-3682
(616) 975-9100
(616) 975-1161
Mailing address
1179 E PARIS AVE SE STE 200, GRAND RAPIDS, MI 49546-3682
(616) 975-9100
(616) 975-1161
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
12/13/2007
Last updated
12/13/2007
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