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Organization

INTERNAL MEDICINE OF WEST MICHIGAN PLLC

Active
Other names
Dr's Marvin, Gans and Roslaniec
Organization subpart
No

Provider details

NPI number
Authorized official
ELIZABETH A KOZAK M.D. (PARTNER)
(616) 285-9090
Entity
Organization

Contact information

Practice address
3200 EAGLE PARK DR NE, SUITE 102, GRAND RAPIDS, MI 49525-7057
(616) 285-9090
(616) 285-7947
Mailing address
3200 EAGLE PARK DR NE, SUITE 102, GRAND RAPIDS, MI 49525-7057
(616) 285-9090
(616) 285-7947

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G02811
BLUE CROSS GROUP NUMBER
MI
Enumeration date
01/16/2007
Last updated
10/25/2024
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