Gastroenterology Specialist Pc

NPI 1003099904 - Internal Medicine - 207RG0100X

NPI Details
NPI 1003099904
Enumeration Date 12/13/2007
Last Updated 12/13/2007
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name DIANE J DIANE
Position MANAGER
Phone (616) 975-9100
Fax (616) 975-1161
Practice Location
1179 E PARIS AVE SE STE 200
GRAND RAPIDS MI, 49546-3682, US
Phone (616) 975-9100
Fax (616) 975-1161
Business Location
1179 E PARIS AVE SE STE 200
GRAND RAPIDS MI, 49546-3682, US
Phone (616) 975-9100
Fax (616) 975-1161
Toxanomy
Taxonomy Code 207RG0100X
License State
License Number
Remove 1003099904 NPI Number
 

According to our database, Gastroenterology Specialist Pc NPI is 1003099904, taxonomy code is 207RG0100X Gastroenterology Specialist Pc physically located at 1179 E Paris Ave Se Ste 200, Grand Rapids MI, 49546-3682. NPI Number 1033115704 has the healthcare provider type.

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1003099904 NPI number is provided on an as is basis without warranty of any kind. 1003099904 is maintained by the National Plan & Provider Enumeration System. The contents of Gastroenterology Specialist Pc are for informational purposes only.