Brookville Pediatric & Internal Medicine, Pc | |
1200 56th St Sw Wyoming MI 49509 | |
(616) 243-5707 | |
(616) 243-1170 |
Full Name | Brookville Pediatric & Internal Medicine, Pc |
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Speciality | Pediatrics |
Location | 1200 56th St Sw, Wyoming, Michigan |
Authorized Official Name and Position | April A. Keizer (ADMINISTRATIVE MANAG) |
Authorized Official Contact | 6165143805 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Brookville Pediatric & Internal Medicine, Pc 8485 Algoma Ave Rockford MI 49341 Ph: (616) 243-5707 | Brookville Pediatric & Internal Medicine, Pc 1200 56th St Sw Wyoming MI 49509 Ph: (616) 243-5707 |
NPI Number | 1346200847 |
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Provider Enumeration Date | 03/27/2006 |
Last Update Date | 04/07/2014 |
Medicare PECOS PAC ID | 0446273510 |
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Medicare Enrollment ID | O20060104000851 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346200847 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (Michigan) | Secondary |
208000000X | Pediatrics | (Michigan) | Primary |
Provider Name | Kelly A Richardson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1548278971 PECOS PAC ID: 4789683053 Enrollment ID: I20061214000167 |
Provider Name | Jane A Post |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1982617817 PECOS PAC ID: 8921103516 Enrollment ID: I20070410000169 |
Provider Name | Brian S Haskin |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1437106648 PECOS PAC ID: 3971681917 Enrollment ID: I20100108000084 |
Provider Name | David E Tiesma |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1922412600 PECOS PAC ID: 3870718034 Enrollment ID: I20180914002024 |
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Metro Health Community Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 781 36th St Se, Wyoming, MI 49548 Phone: 616-252-4100 Fax: 616-252-4953 | |
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Pediatrics Primary Care Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4433 Byron Center Ave Sw, Pediatrics Primary Care, Wyoming, MI 49519 Phone: 616-530-2846 Fax: 616-530-2854 | |
Spectrum Health Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5500 Clyde Park Ave Sw, Wyoming, MI 49509 Phone: 616-486-6790 | |
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