| Spectrum Health Pennock | |
|
9090 S Rodgers Ct Se Caledonia MI 49316-8052 | |
| (616) 891-0422 | |
| Not Available |
| Full Name | Spectrum Health Pennock |
|---|---|
| Speciality | Family Medicine |
| Location | 9090 S Rodgers Ct Se, Caledonia, Michigan |
| Authorized Official Name and Position | Deidre Weller (CONTROLLER) |
| Authorized Official Contact | 2699483122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spectrum Health Pennock 100 Michigan St Ne Mc 845 Grand Rapids MI 49503-2560 Ph: () - | Spectrum Health Pennock 9090 S Rodgers Ct Se Caledonia MI 49316-8052 Ph: (616) 891-0422 |
| NPI Number | 1326495326 |
|---|---|
| Provider Enumeration Date | 05/19/2016 |
| Last Update Date | 05/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326495326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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