| West Michigan Family Practice, Pc | |
|
877 Forest Hill Ave Se Suite C Grand Rapids MI 49546-2380 | |
| (616) 954-0402 | |
| (616) 954-0404 |
| Full Name | West Michigan Family Practice, Pc |
|---|---|
| Speciality | Emergency Medicine |
| Location | 877 Forest Hill Ave Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Daryl M Lawrence-friedl (D.O.) |
| Authorized Official Contact | 6169540402 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Michigan Family Practice, Pc 877 Forest Hills Suite C Grand Rapids MI 49546-2380 Ph: (616) 954-0402 | West Michigan Family Practice, Pc 877 Forest Hill Ave Se Suite C Grand Rapids MI 49546-2380 Ph: (616) 954-0402 |
| NPI Number | 1639382211 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 10/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639382211 | NPI | - | NPPES |
| 1639382211 | Medicaid | MI | |
| DH2054 | Other | MI | RR MEDICARE |
| 0D12216 | Other | MI | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5101010305 (Michigan) | Secondary |
| 207P00000X | Emergency Medicine | 5101010305 (Michigan) | Primary |
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