| Gastroenterology Specialist Pc | |
|
1179 E Paris Ave Se Ste 200 Grand Rapids MI 49546-3682 | |
| (616) 975-9100 | |
| (616) 975-1161 |
| Full Name | Gastroenterology Specialist Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1179 E Paris Ave Se Ste 200, Grand Rapids, Michigan |
| Authorized Official Name and Position | Diane J Atkinson (MANAGER) |
| Authorized Official Contact | 6169759100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Specialist Pc 1179 E Paris Ave Se Ste 200 Grand Rapids MI 49546-3682 Ph: (616) 975-9100 | Gastroenterology Specialist Pc 1179 E Paris Ave Se Ste 200 Grand Rapids MI 49546-3682 Ph: (616) 975-9100 |
| NPI Number | 1003099904 |
|---|---|
| Provider Enumeration Date | 12/13/2007 |
| Last Update Date | 12/13/2007 |
| Medicare PECOS PAC ID | 9537128111 |
|---|---|
| Medicare Enrollment ID | O20041008000361 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003099904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | John P Papp |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417932872 PECOS PAC ID: 3072572668 Enrollment ID: I20041008000479 |
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