Organization
D H ANESTHESIA SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID B HOEKSEMA CRNA (OWNER)
(269) 945-2176
Entity
Organization
Contact information
Practice address
1247 OLD LAKE CT SE, GRAND RAPIDS, MI 49546-4352
(269) 945-2176
(269) 945-0885
Mailing address
1247 OLD LAKE CT SE, GRAND RAPIDS, MI 49546-4352
(269) 945-2176
(269) 945-0885
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704113698
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4308752770
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/12/2007
Last updated
10/24/2007
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