| Tandy L. Champion, D.o., P.c. | |
|
4166 56th St., Sw Grandville MI 49418-2371 | |
| (616) 249-1850 | |
| (616) 532-8657 |
| Full Name | Tandy L. Champion, D.o., P.c. |
|---|---|
| Speciality | Pediatrics |
| Location | 4166 56th St., Sw, Grandville, Michigan |
| Authorized Official Name and Position | Tandy L. Champion (PRESIDENT) |
| Authorized Official Contact | 6162491850 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tandy L. Champion, D.o., P.c. 4166 56th St., Sw Grandville MI 49418-2371 Ph: (616) 249-1850 | Tandy L. Champion, D.o., P.c. 4166 56th St., Sw Grandville MI 49418-2371 Ph: (616) 249-1850 |
| NPI Number | 1619032000 |
|---|---|
| Provider Enumeration Date | 12/26/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619032000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 5101011944 (Michigan) | Primary |
| 208000000X | Pediatrics | 5101011944 (Michigan) | Primary |
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