Individual
JAIME HALVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1175 WILSON AVE NW, WALKER, MI 49534-3493
(616) 685-8650
(616) 791-2160
Mailing address
245 STATE ST SE, GRAND RAPIDS, MI 49503-4328
(616) 685-1808
(616) 685-1850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101014826
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4890959
—
MI
05
—
4890995
—
MI
05
—
4891052
—
MI
05
—
4891061
—
MI
05
—
4891070
—
MI
05
—
4893217
—
MI
Enumeration date
05/23/2006
Last updated
06/26/2009
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