| NPI | 1790803641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL GREVENGOED VP Finance 616-974-4889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-09-10 |