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Contact Information

BRUCE D DRAGOO MD PC
1000 E PARIS AVE SE
SUITE 225
GRAND RAPIDS, MI49546-3691
 Phone: 616-957-3643
 Fax: 616-957-0896
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for BRUCE D DRAGOO MD PC

NPI Number 1952434292
LBN Legal business name BRUCE D DRAGOO MD PC
Authorized official FREDA LARKIN - (BILLING)
Entity Organization
Organization subpart 1 No
Enumeration date 03/14/2007
Last updated 04/20/2008 - About 18 years ago
Identifiers
MI License # 4301028716
MI Medicaid 1083311
MI Other BD028716 BC MI ID NUMBER
MI Other 4301028716 STATE LICENSE NUMBER
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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