| Corewell Health Medical Group West | |
|
3351 Eagle Run Dr Ne Grand Rapids MI 49525-7070 | |
| (616) 454-2004 | |
| (616) 454-0061 |
| Full Name | Corewell Health Medical Group West |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3351 Eagle Run Dr Ne, Grand Rapids, Michigan |
| Authorized Official Name and Position | Polly (pauline) Krywanski (SVP, FINANCE) |
| Authorized Official Contact | 6164862253 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Corewell Health Medical Group West 100 Michigan St Ne Mc845 Grand Rapids MI 49503-2560 Ph: () - | Corewell Health Medical Group West 3351 Eagle Run Dr Ne Grand Rapids MI 49525-7070 Ph: (616) 454-2004 |
| NPI Number | 1437436268 |
|---|---|
| Provider Enumeration Date | 11/08/2011 |
| Last Update Date | 10/31/2023 |
| Certification Date | 10/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437436268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 208800000X | Urology | (* (Not Available)) | Secondary |
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