| Maria E Dimusto-poortenga, MD | |
|
200 Jefferson Ave Se, Nicu, Grand Rapids, MI 49503-4502 | |
| (616) 752-6554 | |
| Not Available |
| Full Name | Maria E Dimusto-poortenga |
|---|---|
| Gender | Female |
| Speciality | Pediatrics - Neonatal-perinatal Medicine |
| Location | 200 Jefferson Ave Se, Grand Rapids, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013940980 | NPI | - | NPPES |
| 0031359 | Medicaid | OH | |
| 4120849 | Medicaid | MI | |
| 4877886 | Medicaid | MI |
| Entity Name | Ascension Medical Group Promed |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497709869 PECOS PAC ID: 7315856077 Enrollment ID: O20031216000478 |
| Mailing Address | Practice Location Address |
|---|---|
| Maria E Dimusto-poortenga, MD 245 State St Se, Grand Rapids, MI 49503-4328 Ph: () - | Maria E Dimusto-poortenga, MD 200 Jefferson Ave Se, Nicu, Grand Rapids, MI 49503-4502 Ph: (616) 752-6554 |
Phillip Richter Paras, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 330 Barclay Ave Ne, Suite 300, Grand Rapids, MI 49503 Phone: 616-391-8810 Fax: 616-391-8897 | |
Nathan Andrew Patterson, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Michigan St Ne # Mc117, Grand Rapids, MI 49503 Phone: 616-267-0118 | |
Stephanie-grace Abinoja Raymundo, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 25 Michigan St Ne Ste 4200, Grand Rapids, MI 49503 Phone: 616-267-9150 | |
William B Stratbucker, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 35 Michigan St Ne Ste 1800, Grand Rapids, MI 49503 Phone: 616-391-7999 | |
Wesley Hannah Shane, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Michigan St Ne, Grand Rapids, MI 49503 Phone: 866-989-7999 | |
Caroline Buckley, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 330 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 Phone: 616-391-8810 | |
Dr. Susan H Wakefield, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 877 Forest Hill Ave Se, Grand Rapids, MI 49546 Phone: 616-949-4465 Fax: 616-949-6191 |