Individual
DR. GARY DAVID POELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3355 EAGLE PARK DR NE, STE103, GRAND RAPIDS, MI 49525-7004
(616) 942-7400
Mailing address
3713 NORTON HILLS RD, NORTON SHORES, MI 49441-4469
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
GP043454
MI
207QG0300X
Geriatric Medicine (Family Medicine) Physician
GP043454
MI
208D00000X
General Practice Physician
Primary
GP043454
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0107001012
BCBS
—
01
—
117141PC
CCHMO,CCPPO,MERCY
—
01
—
152750
PHCS
—
01
—
40099285
AETNA
—
01
—
B43739
PRIORITY HEALTH
—
Enumeration date
04/03/2007
Last updated
09/14/2015
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