Dr Brian Mitchell Boville, MD | |
100 Michigan St Ne, Grand Rapids, MI 49503-2560 | |
(616) 267-0118 | |
(616) 267-0090 |
Full Name | Dr Brian Mitchell Boville |
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Gender | Male |
Speciality | Anesthesiology - Critical Care Medicine |
Location | 100 Michigan St Ne, Grand Rapids, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902863871 | NPI | - | NPPES |
1902863871 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0203X | Pediatrics - Pediatric Critical Care Medicine | 4301100059 (Michigan) | Secondary |
207LC0200X | Anesthesiology - Critical Care Medicine | 4301100059 (Michigan) | Primary |
Entity Name | Spectrum Health Primary Care Partners |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1235188673 PECOS PAC ID: 4587568647 Enrollment ID: O20031121000091 |
Mailing Address | Practice Location Address |
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Dr Brian Mitchell Boville, MD 100 Michigan St Ne, Mc 845, Grand Rapids, MI 49503-2560 Ph: () - | Dr Brian Mitchell Boville, MD 100 Michigan St Ne, Grand Rapids, MI 49503-2560 Ph: (616) 267-0118 |
Matthew H Armstrong, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 100 Michigan St Ne, Grand Rapids, MI 49503 Phone: 616-364-4200 | |
Daniel H. Robinson, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 200 Jefferson Ave Se, Grand Rapids, MI 49503 Phone: 616-685-5000 | |
Cheryl Lukins, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 25 Michigan St Ne Ste 2200, Grand Rapids, MI 49503 Phone: 616-391-3245 | |
Dr. Jeffrey M Ricketts, DO Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 3333 Evergreen Dr Ne, Grand Rapids, MI 49525 Phone: 616-364-4200 Fax: 616-364-7347 | |
Christopher Ross Russo, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 710 Kenmoor Ave Se, Suite 200, Grand Rapids, MI 49546 Phone: 616-588-7246 Fax: 616-588-7086 | |
Samuel Lee, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 100 Michign St Ne, Grand Rapids, MI 49503 Phone: 616-364-4200 | |
Dr. Cindy Chu, DO Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 200 Jefferson Ave Se, Grand Rapids, MI 49503 Phone: 616-685-5000 |