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Individual

ERIC JAMES WIELHOUWER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3185 MACATAWA DR SW, SUITE A, GRANDVILLE, MI 49418-3163
(616) 391-4500
(616) 486-0130
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
(616) 486-0130

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101015494
MI
208000000X
Pediatrics Physician
5101015494
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114985130
MI
Enumeration date
03/15/2007
Last updated
02/22/2021
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