Organization
WEST MICHIGAN CARDIOLOGY, PC
Active
Other names
West Michigan Cardiology
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN A TARATUTA (PRACTICE MANAGER)
(616) 456-9553
Entity
Organization
Contact information
Practice address
3210 EAGLE RUN DR NE STE 100, GRAND RAPIDS, MI 49525-7051
(616) 456-9553
(616) 454-5371
Mailing address
PO BOX 150036, GRAND RAPIDS, MI 49515-0036
(616) 456-9553
(616) 454-5371
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
TM058656
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060E960210
BLUE SHIELD
MI
01
—
161
PRIORITY HEALTH
MI
Enumeration date
10/05/2006
Last updated
05/14/2024
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