| J Patrick Duiven Psyd Pc | |
|
4133 Embassy Dr Se Grand Rapids MI 49546-2418 | |
| (616) 956-6700 | |
| (616) 956-6773 |
| Full Name | J Patrick Duiven Psyd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 4133 Embassy Dr Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | J Patrick Duiven (PRESIDENT/OWNER) |
| Authorized Official Contact | 6169566700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J Patrick Duiven Psyd Pc 4133 Embassy Dr Se Grand Rapids MI 49546-2418 Ph: (616) 956-6700 | J Patrick Duiven Psyd Pc 4133 Embassy Dr Se Grand Rapids MI 49546-2418 Ph: (616) 956-6700 |
| NPI Number | 1124328265 |
|---|---|
| Provider Enumeration Date | 10/22/2010 |
| Last Update Date | 10/22/2010 |
| Medicare PECOS PAC ID | 1153516323 |
|---|---|
| Medicare Enrollment ID | O20170306000786 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124328265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301002423 (Michigan) | Primary |
| Provider Name | John Patrick Duiven |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972685527 PECOS PAC ID: 2062607237 Enrollment ID: I20170306000606 |
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