Organization
MICHIGAN MEDICAL, PC.
Active
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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