Organization
WESTERN MICHIGAN PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L VAN ZEE M.D. (TREASURER)
(616) 949-6112
Entity
Organization
Contact information
Practice address
710 KENMOOR AVE SE, SUITE 110, GRAND RAPIDS, MI 49546-2379
(616) 949-6112
(616) 949-8530
Mailing address
721 KENMOOR AVE SE, GRAND RAPIDS, MI 49546
(616) 949-6112
(616) 949-8530
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D16244
BCBS OF MICHIGAN PIN
MI
Enumeration date
03/27/2007
Last updated
09/27/2018
Update your record
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