| Digestive Diseases Specialists Pc | |
|
1200 East Paris Ave Se Ste 8 Grand Rapids MI 49546-8260 | |
| (616) 942-6230 | |
| (616) 942-6270 |
| Full Name | Digestive Diseases Specialists Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1200 East Paris Ave Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Asif Azeem (OWNER) |
| Authorized Official Contact | 6169426230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Digestive Diseases Specialists Pc Po Box 3405 Evansville IN 47733-3405 Ph: (616) 457-9000 | Digestive Diseases Specialists Pc 1200 East Paris Ave Se Ste 8 Grand Rapids MI 49546-8260 Ph: (616) 942-6230 |
| NPI Number | 1033101977 |
|---|---|
| Provider Enumeration Date | 08/17/2005 |
| Last Update Date | 05/21/2015 |
| Medicare PECOS PAC ID | 4587684220 |
|---|---|
| Medicare Enrollment ID | O20051128000190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033101977 | NPI | - | NPPES |
| P00083034 | Other | RR MEDICARE | |
| 1004112961 | Other | MI | BC/BS |
| 104554722 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Asif Azeem |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932288248 PECOS PAC ID: 6204856941 Enrollment ID: I20090416000694 |
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