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230 S Maple St Grant MI 49327-9006 | |
(231) 834-5995 | |
(231) 834-0248 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 230 S Maple St, Grant, Michigan |
Authorized Official Name and Position | Randall J Stasik (PRESIDENT) |
Authorized Official Contact | 2319241340 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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100 Michigan St Ne # Mc845 Grand Rapids MI 49503-2560 Ph: () - | 230 S Maple St Grant MI 49327-9006 Ph: (231) 834-5995 |
NPI Number | 1013040492 |
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Provider Enumeration Date | 03/14/2007 |
Last Update Date | 06/03/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013040492 | NPI | - | NPPES |
4383367 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (Michigan) | Primary |
Grant Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 S Maple, Grant, MI 49327 Phone: 231-834-5995 Fax: 231-834-0248 | |
Gerald Van Wieren, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 71 S Front St, Grant, MI 49327 Phone: 231-834-5676 Fax: 231-834-7211 | |