Organization · NPI-2

Age Management And Hormone Balance Center

Internal Medicine · Grand Rapids, MI

NPI number1730417288
StatusActive
Last updated in NPPESSep 17, 2012

Details

NPI
1730417288
Entity type
Organization (NPI-2)
Legal business name
Age Management And Hormone Balance Center
Organization subpart
No
Enumeration date
Nov 20, 2009
Last updated
Sep 17, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine4301076867MIYes

Practice location

1787 Grand Ridge Ct Ne
Suite 202
Grand Rapids, MI 49525-7042

Phone 616-808-2695 · Fax 616-808-2697

Mailing address

1787 Grand Ridge Ct Ne
Suite 202
Grand Rapids, MI 49525-7042

Phone 616-808-2695 · Fax 616-808-2697

Authorized official

Piyush Bhatnagar
Internist-Managing Director
6168082695

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Internal Medicine providers in Grand Rapids, MI