Individual
TIMOTHY J HULST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2144 E. PARIS AVE. SE, STE 100, GRAND RAPIDS, MI 49546
(616) 281-0666
(616) 281-0752
Mailing address
2144 E. PARIS AVE. SE, STE 100, GRAND RAPIDS, MI 49546
(616) 281-0666
(616) 281-0752
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901001793
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1266510003
ADMINISTAR
MI
05
—
3506880
—
MI
01
—
480026384
RAILROAD MEDICARE
MI
Enumeration date
06/19/2006
Last updated
01/05/2022
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