Pediatric Surgeons Of West Michigan PC
Surgery in Grand Rapids, MI. Organization (NPI-2).
NPI number1477516110
StatusActive
Last updated in NPPESMar 8, 2017
Details
- NPI
- 1477516110
- Entity type
- Organization (NPI-2)
- Legal business name
- Pediatric Surgeons Of West Michigan PC
- Organization subpart
- No
- Enumeration date
- Apr 11, 2006
- Last updated
- Mar 8, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | – | – | Yes |
Practice location
330 Barclay NeSuite 202
Grand Rapids, MI 49503
Phone 616-458-1722 · Fax 616-458-0061
Mailing address
330 Barclay NeSuite 202
Grand Rapids, MI 49503
Phone 616-458-1722 · Fax 616-458-0061
Authorized official
Jennifer L Jamula
Practice Manager
6164581722
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