| Macatawa Family Medicine, PLLC | |
|
1061 Washington Ave Holland MI 49423-5216 | |
| (616) 393-8100 | |
| (877) 451-0226 |
| Full Name | Macatawa Family Medicine, PLLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1061 Washington Ave, Holland, Michigan |
| Authorized Official Name and Position | Diane C Eddington (OFFICE MGR) |
| Authorized Official Contact | 6163938100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Macatawa Family Medicine, PLLC 1061 Washington Ave Holland MI 49423-5216 Ph: (616) 393-8100 | Macatawa Family Medicine, PLLC 1061 Washington Ave Holland MI 49423-5216 Ph: (616) 393-8100 |
| NPI Number | 1760156046 |
|---|---|
| Provider Enumeration Date | 08/02/2021 |
| Last Update Date | 05/20/2022 |
| Certification Date | 05/20/2022 |
| Medicare PECOS PAC ID | 7315331964 |
|---|---|
| Medicare Enrollment ID | O20220225000509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760156046 | NPI | - | NPPES |
| 900149064 | Other | MI | PRIORITY HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Shaena Freeman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023490943 PECOS PAC ID: 5193030476 Enrollment ID: I20180719001220 |
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