National Provider Identifier Database

MARIA E DIMUSTO POORTENGA, MD – NPI #1013940980
Neonatal-Perinatal Medicine

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.


Contact Information

MARIA E DIMUSTO POORTENGA, MD
200 JEFFERSON AVE SE
NICU
GRAND RAPIDS, MI49503-4502
Phone: 616-752-6554
Fax:
Website:
Specialty Taxonomy Code
* Neonatal-Perinatal Medicine 2080N0001X
Pediatrics 208000000X

* Indicates primary specialty

NPI Profile & details for MARIA E DIMUSTO POORTENGA

NPI Number 1013940980
Credentials MD
Entity Individual
Enumeration date 07/07/2006
Last updated 12/05/2023 - About 3 years ago
Sole proprietor1 No
Identifiers
  • FL License #: ME141884
  • MI License #: 1013940980
  • MI License #: 4301068818
  • OH License #: 35C001071
  • MI Medicaid: 4120849
  • MI Medicaid: 4877886
  • OH Medicaid: 0031359
Hospital affiliation n/a

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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