Individual
MISS MELINDA SUE HINTERMEISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9606
(616) 364-4200
(616) 364-7347
Mailing address
3333 EVERGREEN DR NE STE 100, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
(616) 364-7347
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
02006416A
IN
207L00000X
Anesthesiology Physician
036110981
IL
207L00000X
Anesthesiology Physician
03617
IA
207L00000X
Anesthesiology Physician
Primary
5101014927
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0463869
—
IA
05
—
1871579565
—
MI
01
—
264430G93
MEDICARE
IN
05
—
300063902
—
IN
Enumeration date
12/15/2005
Last updated
10/21/2024
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