| Creston Medical Service, Pc | |
|
1330 Plainfield Ave Ne Grand Rapids MI 49505-5091 | |
| (616) 776-1275 | |
| (616) 776-3713 |
| Full Name | Creston Medical Service, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1330 Plainfield Ave Ne, Grand Rapids, Michigan |
| Authorized Official Name and Position | Peter Beardslee App (PRESIDENT) |
| Authorized Official Contact | 6167761275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creston Medical Service, Pc Po Box 264 Grand Rapids MI 49501-0264 Ph: (616) 776-1275 | Creston Medical Service, Pc 1330 Plainfield Ave Ne Grand Rapids MI 49505-5091 Ph: (616) 776-1275 |
| NPI Number | 1043653082 |
|---|---|
| Provider Enumeration Date | 04/09/2013 |
| Last Update Date | 04/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043653082 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301029675 (Michigan) | Primary |
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