Organization
MICHIGAN MEDICAL PATIENT CARE
Active
Parent organization
MICHIGAN MEDICAL PATIENT CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICHIGAN MEDICAL PATIENT CARE
Authorized official
SCOTT HARRING (CFO)
(616) 974-4889
Entity
Organization
Contact information
Practice address
4100 LAKE DR SE, SUITE 300, GRAND RAPIDS, MI 49546-8292
(616) 974-4889
Mailing address
4085 BURTON ST SE, SUITE 200, GRAND RAPIDS, MI 49546-2444
(616) 974-4889
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500D116710
BCBS PIN
MI
Enumeration date
12/29/2006
Last updated
03/02/2010
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