Organization
GRAND RIVER EMERGENCY MEDICAL GROUP PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK FIGURSKI MD (PRESIDENT OF GROUP)
(800) 968-6866
Entity
Organization
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 685-6781
Mailing address
PO BOX Q, GRAND RAPIDS, MI 49501-4917
(800) 968-6866
(616) 532-7230
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101007471
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010D160910
BLUE CROSS BLUE SHIELD
—
01
—
500D111750
BLUE CROSS BLUE SHIELD
—
Enumeration date
06/01/2005
Last updated
02/04/2013
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