Organization
WKQ INC DBA NORTHSIDE IMMEDIATE CARE CENTER
Active
Other names
northside immediate care urgent care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERWIN L GRASMAN M.D. (OWNER/PRESIDENT)
(231) 744-4743
Entity
Organization
Contact information
Practice address
420 WHITEHALL RD, SUITE 4, N MUSKEGON, MI 49445-3299
(231) 744-4743
(231) 744-4745
Mailing address
420 WHITEHALL RD, SUITE 4, N MUSKEGON, MI 49445-3299
(231) 744-4743
(231) 744-4745
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F11097
BCN UCC
MI
01
—
0F16019
BCBS MI
MN
Enumeration date
10/04/2007
Last updated
10/04/2007
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