| NPI | 1255361598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER VIDEAN Provider Enrollment Specialist 616-532-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 0000000000) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2010-12-23 |