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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