| 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 |