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ALLERGY & ASTHMA CARE OF W MI PC NPI 1518902022


NPI Information

NPI: 1518902022
Provider Name: ALLERGY & ASTHMA CARE OF W MI PC

Former Legal Business Name: ALLERGY CONSULTANT SERVICES PC

Classification: Allergy & Immunology - 207K00000X
Entity Type: Organization

CLIA Number: 23D0380849

Address:
1179 EAST PARIS SE
SUITE 150
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 957-1912
Get Directions

ALLERGY & ASTHMA CARE OF W MI PC is an allergy immunology in Grand Rapids, MI. The provider is an allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. ALLERGY & ASTHMA CARE OF W MI PC NPI is 1518902022. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Allergy Consultant Services Pc.

The provider's business location address is:

1179 EAST PARIS SE
SUITE 150
GRAND RAPIDS, MI
ZIP 49546-680
Phone: (616) 957-1912
Fax: (616) 957-0074

The provider's authorized official is Mark M Millar .
The authorized official title is President and has the following contact phone number (616) 957-1912.

The CLIA number assigned to this NPI record is 23D0380849 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/18/2006 and was last updated on 5/14/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207K00000XAllergy & Immunology4301071401MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G78098MEDICARE UPIN
2347887810MEDICAIDMICHIGAN
3N99890001MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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