Organization
GASTROENTEROLOGY INSTITUTE OF WEST MICHIGAN PC
Active
Organization
GASTROENTEROLOGY INSTITUTE OF WEST MICHIGAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUKAT ALI KHAN MD (DOCTOR)
(616) 459-6146
Entity
Organization
Contact information
Practice address
1430 MICHIGAN ST NE, SUITE A, GRAND RAPIDS, MI 49503-2006
(616) 459-6146
(616) 459-9277
Mailing address
4100 EMBASSY DR SE, SUITE 200, GRAND RAPIDS, MI 49546-2416
(616) 459-6146
(616) 459-9277
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D11782
BCBS
MI
05
—
1082851
—
MI
01
—
CE4135
RAILROAD MEDICARE
MI
Enumeration date
09/15/2006
Last updated
07/21/2022
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