| Dr Randall Norton Clark, MD | |
|
3980 Chicago Dr Sw Ste 200, Grandville, MI 49418-1392 | |
| (616) 381-5181 | |
| (616) 381-5178 |
| Full Name | Dr Randall Norton Clark |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 3980 Chicago Dr Sw Ste 200, Grandville, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063573319 | NPI | - | NPPES |
| 080D14848 | Other | MI | BCBS PROVIDER ID |
| 2851933 | Medicaid | MI | |
| RC050413 | Other | MI | STATE LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | RC050413 (Michigan) | Primary |
| Entity Name | Riverwood Family Medicine PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972677656 PECOS PAC ID: 7911930060 Enrollment ID: O20050919000172 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Randall Norton Clark, MD 3980 Chicago Dr Sw Ste 200, Grandville, MI 49418-1392 Ph: (616) 381-5181 | Dr Randall Norton Clark, MD 3980 Chicago Dr Sw Ste 200, Grandville, MI 49418-1392 Ph: (616) 381-5181 |
Dr. Carly Rose Quinn, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3185 Macatawa Dr Sw Ste A, Grandville, MI 49418 Phone: 616-391-4500 |
Alice Schlaepfer, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3380 44th St Sw, Grandville, MI 49418 Phone: 616-685-8250 Fax: 616-532-3564 |
Thomas Macholan, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3380 44th St Sw, Grandville, MI 49418 Phone: 616-685-8250 Fax: 616-532-9564 |
Dr. Lauren Zedan Blenman, D.O Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 6105 Wilson Ave Sw Ste 204, Grandville, MI 49418 Phone: 616-486-5421 |
Morgan Daul, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3380 44th St Sw, Grandville, MI 49418 Phone: 616-685-8250 Fax: 616-532-3564 |
Tomasz Rafal Stankiewicz, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3380 44th St Sw, Grandville, MI 49418 Phone: 616-685-8250 Fax: 616-532-3564 |
Paul A Woods, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 6105 Wilson Ave Sw, Suite 204, Grandville, MI 49418 Phone: 616-486-5421 Fax: 616-486-5051 |