Individual
ERICA A MICHIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 391-1680
Mailing address
2537 MOMENTUM PL, CHICAGO, IL 60689-5325
(616) 975-1845
(616) 285-0846
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301098340
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
4301098340
MI
208000000X
Pediatrics Physician
ML20008077
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0412286
BCBSM PIN
MI
Enumeration date
09/15/2006
Last updated
05/21/2012
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