Organization
FAMILY PRACTICE ASSOCIATES OF WEST MICHIGAN P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS SETH VANWORMER D.O. (OWNER, PRESIDENT)
(616) 975-2550
Entity
Organization
Contact information
Practice address
6735 CASCADE RD SE, SUITE 100, GRAND RAPIDS, MI 49546-6887
(616) 975-2550
(616) 975-2555
Mailing address
6735 CASCADE RD SE, SUITE 100, GRAND RAPIDS, MI 49546-6887
(616) 975-2550
(616) 975-2555
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MI 5101009001
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ON13300
MEDICARE PTAN
MI
Enumeration date
08/12/2010
Last updated
08/12/2010
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