Organization
HEALTHY FAMILY PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUPERTO DIVINO BLANCO JR. M.D. (OWNER)
(616) 827-2020
Entity
Organization
Contact information
Practice address
2021 44TH ST SE, SUITE C, GRAND RAPIDS, MI 49508-5349
(616) 827-2020
Mailing address
2021 44TH ST SE, SUITE C, GRAND RAPIDS, MI 49508-5349
(616) 827-2020
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790736643
NPI FOR DR. BLANCO
MI
Enumeration date
11/28/2006
Last updated
08/22/2020
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