| Michael J Bultje, DO | |
|
2093 Health Dr Sw, Ste 200, Wyoming, MI 49519-9691 | |
| (616) 459-3158 | |
| (616) 819-2222 |
| Full Name | Michael J Bultje |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 26 Years |
| Location | 2093 Health Dr Sw, Wyoming, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144224882 | NPI | - | NPPES |
| 4426277 | Medicaid | MI | |
| 38-2145264 | Other | MI | IRS TAX ID # THRU NEW EMPLOYER EFFECTIVE 6/30/09 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5101014160 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Spectrum Health | Grand rapids, MI | Hospital |
| Metro Health Hospital | Wyoming, MI | Hospital |
| Mercy Health Saint Mary's | Grand rapids, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Grand Valley Medical Specialists Plc | 1254311947 | 21 |
| Entity Name | Grand Valley Medical Specialists Plc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033226402 PECOS PAC ID: 1254311947 Enrollment ID: O20040722001223 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael J Bultje, DO 2093 Health Dr Sw, Ste 200, Wyoming, MI 49519-9691 Ph: (616) 459-3158 | Michael J Bultje, DO 2093 Health Dr Sw, Ste 200, Wyoming, MI 49519-9691 Ph: (616) 459-3158 |
Dr. Tristan J Worthington, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 5900 Byron Center Ave Sw, Wyoming, MI 49519 Phone: 616-252-7200 Fax: 616-252-4953 | |
Mark W Newberry, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 5838 Metro Way Sw, Wyoming, MI 49519 Phone: 616-249-5300 | |
John W Hamersma, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2093 Health Dr Sw, Ste 200, Wyoming, MI 49519 Phone: 616-459-3158 Fax: 616-819-2222 | |
Alan Michael Young, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 950 36th St Sw, Wyoming, MI 49509 Phone: 616-685-3300 Fax: 616-685-3303 | |
Dr. Richard J Stang, D.O Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 3011 Sandy Ct Sw, Wyoming, MI 49418 Phone: 616-272-3909 | |
Scott A Johnson, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2215 44th St Sw, Wyoming, MI 49519 Phone: 616-252-8300 Fax: 616-252-8460 |