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Contact Information

INTERNAL MEDICINE OUTPATIENT SERVICES, PC
2795 ORANGE AVE
GRAND RAPIDS, MI49546
 Phone: 616-954-2099
 Fax: 616-949-5355
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for INTERNAL MEDICINE OUTPATIENT SERVICES, PC

NPI # 1215009022
LBN Legal business name INTERNAL MEDICINE OUTPATIENT SERVICES, PC
Authorized official AMANDA HUVER - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/15/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
MI License # 5101010570
MI Medicaid 4341483
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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