| NPI | 1962941518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BRIAN BLOCHER President/CEO 616-340-7079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301030071) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 1419845) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2017-02-15 |