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Contact Information

ADDRESS HEALTHCARE OF MICHIGAN PLLC
600 MONROE AVENUE NW
STE 104
GRAND RAPIDS, MI49503-1470
 Phone: 616-366-4234
 Fax: 855-548-4481
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Adult Health

363LA2200X 50 Nurse Practitioner
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Hospice and Palliative Medicine

207RH0002X 11 Physician/Internal Medicine
 

Optometrist

152W00000X 41 Optometry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for ADDRESS HEALTHCARE OF MICHIGAN PLLC · (Female)

NPI Number 1043075294
Status Active
Credentials
Entity Individual
Enumeration date 02/16/2024
Last updated 05/05/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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