Organization
MICHIGAN MEDICAL, PC.
Active
Other names
Grand Rapids OBGyn
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL GREVENGOED (VP OF FINANCE AND REIMBURSEMENT)
(616) 974-4889
Entity
Organization
Contact information
Practice address
3800 LAKE MICHIGAN DR NW, SUITE A, GRAND RAPIDS, MI 49534-4583
(616) 453-8225
Mailing address
4085 BURTON ST SE, SUITE 200, GRAND RAPIDS, MI 49546-2444
(616) 974-4889
(616) 974-4582
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/15/2006
Last updated
08/22/2020
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