Unknown Individual – Family Medicine Physician, NPI 1689674756
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
985, Gezon Parkway Southwest, Wyoming, Kent County, Michigan, 49509, United States
ATTN: TERESA MCNALLY
WYOMING, MI 495099563
Phone: (616) 252-4655
Fax: (616) 252-0103
Type: Mailing
1925, Breton Road Southeast, Third Ward, East Grand Rapids, Kent County, Michigan, 49506, United States
GRAND RAPIDS, MI 495064810
Phone: (616) 252-4100
Fax: (616) 252-4953
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
Source: CMS public data · Not endorsed by CMS ·
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 ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 49509)
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