Organization
RENAL ASSOCIATES OF WEST MICHIGAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK R BOELKINS MD (MD)
(616) 752-6235
Entity
Organization
Contact information
Practice address
330 E BELTLINE AVE NE, SUITE 100, GRAND RAPIDS, MI 49506-1267
(616) 752-6235
(616) 752-6324
Mailing address
330 E BELTLINE AVE NE, SUITE 100, GRAND RAPIDS, MI 49506-1267
(616) 752-6235
(616) 752-6324
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871674200
—
MI
Enumeration date
10/19/2006
Last updated
01/17/2020
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