| Michael Kenneth Hofman, | |
| 
					2093 Health Dr Sw Ste 200, Wyoming, MI 49519-9691  | |
| (616) 459-3158 | |
| (616) 819-2222 | 
| Full Name | Michael Kenneth Hofman | 
|---|---|
| Gender | Male | 
| Speciality | Internal Medicine | 
| Location | 2093 Health Dr Sw Ste 200, Wyoming, Michigan | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1710541404 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 4301510242 (Michigan) | Secondary | 
| 207R00000X | Internal Medicine | 4301510242 (Michigan) | Primary | 
| 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 Kenneth Hofman, 2128 Chesaning Dr Se, Grand Rapids, MI 49506-5311 Ph: (616) 581-3606  | Michael Kenneth Hofman, 2093 Health Dr Sw Ste 200, Wyoming, MI 49519-9691 Ph: (616) 459-3158  | 
Mark J Tieszen, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5900 Byron Center Ave Sw, Wyoming, MI 49519 Phone: 616-252-7200  | |
William Marc Katz, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 2093 Health Dr Sw, Ste 200, Wyoming, MI 49519 Phone: 616-459-3158 Fax: 616-819-2222  | |
Dr. Srinivas Reddy Mummadi, MBBS Internal Medicine Medicare: Medicare Enrolled Practice Location: 2122 Health Dr Sw, Wyoming, MI 49519 Phone: 616-252-5220 Fax: 616-252-5770  | |
Kurt Koepnick, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 6105 Wilson Ave Sw, Suite 202, Wyoming, MI 49418 Phone: 616-267-7220  | |
Dr. Heidi Lynn Putt, DO Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5838 Metro Way Sw, Wyoming, MI 49519 Phone: 616-249-5300  | |
Dr. John Allen Key, DO Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5900 Byron Center Ave Sw, Wyoming, MI 49519 Phone: 616-241-2333 Fax: 616-452-6767  | |
Danielle Light, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5900 Byron Center Ave Sw, Wyoming, MI 49519 Phone: 616-252-7200  |