Individual provider · NPI-1

Jennifer Bach, D.O.

Emergency Medicine · Grand Rapids, MI

NPI number1598189458
StatusActive
Last updated in NPPESAug 21, 2023

Details

NPI
1598189458
Entity type
Individual (NPI-1)
Name
Jennifer Bach
Credential
D.O.
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 13, 2014
Certification date
Aug 21, 2023
Last updated
Aug 21, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207P00000X Emergency Medicine5101020864MIYes

Practice location

100 Michigan St Ne
Grand Rapids, MI 49503-2560

Phone 616-988-8220

Mailing address

100 Michigan St Ne
Grand Rapids, MI 49503-2560

Phone 616-988-8220

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