Organization
WEST MICHIGAN CARDIOTHORACIC SURGEONS PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY J MOSLEY BS (PRACTICE ADMINISTRATOR)
(616) 459-7258
Entity
Organization
Contact information
Practice address
100 MICHIGAN ST NE, SUITE 8830, GRAND RAPIDS, MI 49503-2560
(616) 459-7258
(616) 459-5215
Mailing address
100 MICHIGAN ST NE, MC 103, GRAND RAPIDS, MI 49503-2560
(616) 459-7258
(616) 459-5215
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330D16173
BCBSM
—
Enumeration date
02/06/2006
Last updated
06/20/2013
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