Organization
WEST MICHIGAN GASTROENTEROLOGY PLC
Active
Organization
WEST MICHIGAN GASTROENTEROLOGY PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN P EGAN JR. MD (CHIEF EXECUTIVE OFFICER)
(231) 726-5075
Entity
Organization
Contact information
Practice address
1675 LEAHY, SUITE 324B, MUSKEGON, MI 49442-5500
(231) 726-5075
(231) 722-1827
Mailing address
1675 LEAHY, SUITE 324B, MUSKEGON, MI 49442-5500
(231) 726-5075
(231) 722-1827
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM6445
RAILROAD MEDICARE
MI
Enumeration date
12/09/2006
Last updated
12/11/2007
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