NPI | 1790470409 |
---|---|
Doing Business As | 12TH STREET INTERNAL MEDICINE AND PEDIATRICS |
Entity Type | Organization |
Authorized Contact | JOEL VELDHOUSE Physician Owner 616-648-4933 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 208000000X Pediatrics |
Enumeration Date | 2023-04-07 |
Last Update Date | 2023-08-15 |