Unknown Individual – Family Medicine Physician, NPI 1407830490
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Spectrum Health Butterworth Hospital, 100, Michigan Street Northeast, Grand Rapids, Kent County, Michigan, 49503, United States
MC 845
GRAND RAPIDS, MI 495032560
Phone:
Type: Mailing
1202, West Oak Street, Greenville, Montcalm County, Michigan, 48838, United States
SUITE 200
GREENVILLE, MI 488382155
Phone: (616) 754-4685
Fax: (616) 754-9883
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 49503)
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