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Organization

FERRIS STATE UNIVERSITY

Active
Other names
Birkam Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. R PAUL SULLIVAN PHD (DIRECTOR)
(231) 591-2616
Entity
Organization

Contact information

Practice address
1019 CAMPUS DR, BIG RAPIDS, MI 49307-2280
(231) 591-2614
(231) 591-5970
Mailing address
1019 CAMPUS DR, BIG RAPIDS, MI 49307-2280
(231) 591-2614
(231) 591-5970

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301040919
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0E46000
BLUE SHIELD
MI
Enumeration date
05/09/2007
Last updated
06/16/2008
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