| Internal Medicine Outpatient Services, Pc | |
| 
					2795 Orange Ave Grandrapids MI 49546  | |
| (616) 954-2099 | |
| (616) 949-5355 | 
| Full Name | Internal Medicine Outpatient Services, Pc | 
|---|---|
| Speciality | Internal Medicine | 
| Location | 2795 Orange Ave, Grandrapids, Michigan | 
| Authorized Official Name and Position | Amanda Melissa Huver (PRESIDENT) | 
| Authorized Official Contact | 6169542099 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Internal Medicine Outpatient Services, Pc 2795 Orange Ave Grandrapids MI 49546 Ph: (616) 954-2099  | Internal Medicine Outpatient Services, Pc 2795 Orange Ave Grandrapids MI 49546 Ph: (616) 954-2099  | 
| NPI Number | 1215009022 | 
|---|---|
| Provider Enumeration Date | 11/15/2006 | 
| Last Update Date | 08/22/2020 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1215009022 | NPI | - | NPPES | 
| 4341483 | Medicaid | MI | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | 5101010570 (Michigan) | Primary |