| 12th Street Internal Medicine And Pediatrics | |
|
3587 12th St Wayland MI 49348-9569 | |
| (616) 648-4933 | |
| Not Available |
| Full Name | 12th Street Internal Medicine And Pediatrics |
|---|---|
| Speciality | Internal Medicine |
| Location | 3587 12th St, Wayland, Michigan |
| Authorized Official Name and Position | Joel Veldhouse (PHYSICIAN OWNER) |
| Authorized Official Contact | 6166484933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 12th Street Internal Medicine And Pediatrics 3587 12th St Wayland MI 49348-9569 Ph: () - | 12th Street Internal Medicine And Pediatrics 3587 12th St Wayland MI 49348-9569 Ph: (616) 648-4933 |
| NPI Number | 1790470409 |
|---|---|
| Provider Enumeration Date | 04/07/2023 |
| Last Update Date | 08/15/2023 |
| Medicare PECOS PAC ID | 8325405566 |
|---|---|
| Medicare Enrollment ID | O20230605000318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790470409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Joel Patrick Veldhouse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659685741 PECOS PAC ID: 7517195795 Enrollment ID: I20140911001699 |
| Provider Name | Linnelle Veldhouse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366679961 PECOS PAC ID: 1254550593 Enrollment ID: I20140918000107 |
| Provider Name | Lisa M Striegle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770904229 PECOS PAC ID: 8325349939 Enrollment ID: I20151223000551 |
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