Organization · NPI-2

Beaumont Medical Group- Specialty Services

Internal Medicine · Trenton, MI

NPI number1629940705
StatusActive
Last updated in NPPESSep 19, 2025

Details

NPI
1629940705
Entity type
Organization (NPI-2)
Legal business name
Beaumont Medical Group- Specialty Services
Organization subpart
No
Enumeration date
Sep 19, 2025
Certification date
Sep 19, 2025
Last updated
Sep 19, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes

Practice location

5452 Fort St
Trenton, MI 48183-4637

Phone 616-486-6790

Mailing address

100 Michigan St Ne
Grand Rapids, MI 49503-2560

Authorized official

Matthew E Cox
Cfo
6162954264

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