Individual
SCOTT M TUINSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3299 N WELLNESS DR, BUILDING C; SUITE 240, HOLLAND, MI 49424-7269
(616) 738-4420
(616) 738-4432
Mailing address
3299 N WELLNESS DR, BUILDING C; SUITE 240, HOLLAND, MI 49424-7269
(616) 738-4420
(616) 738-4432
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5601003962
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104721043
—
MI
01
—
1407010792
BXMI
MI
01
—
OD14869
GROUP PTAN - OAM
MI
01
—
ST003962
STATE LICENSE
MI
Enumeration date
10/06/2006
Last updated
12/16/2013
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