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Individual

HARVEY J DEMAAGD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2332 ALPINE AVE NW, GRAND RAPIDS, MI 49544-1955
(616) 391-6220
Mailing address
100 MICHIGAN ST NE, MC 109 ATTN JULIE L, GRAND RAPIDS, MI 49503-2560

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301025984
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1598712390
GROUP NPI
MI
05
4822799
MI
05
4822805
MI
05
4822814
MI
05
4822832
MI
01
700D114790
BCBS GROUP #
MI
Enumeration date
05/04/2006
Last updated
04/12/2012
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