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INTERNAL MEDICINE OF WEST MICHIGAN PLLC NPI 1619028412


NPI Information

NPI: 1619028412
Provider Name: INTERNAL MEDICINE OF WEST MICHIGAN PLLC

Former Legal Business Name: DR'S MARVIN, GANS AND ROSLANIEC

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 23D1015125

Address:
3200 EAGLE PARK DR NE
SUITE 102
GRAND RAPIDS, MI
ZIP 49525
Phone: (616) 285-9090
Get Directions

INTERNAL MEDICINE OF WEST MICHIGAN PLLC is an internal medicine in Grand Rapids, MI. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. INTERNAL MEDICINE OF WEST MICHIGAN PLLC NPI is 1619028412. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Dr's Marvin, Gans And Roslaniec.

The provider's business location address is:

3200 EAGLE PARK DR NE
SUITE 102
GRAND RAPIDS, MI
ZIP 49525-057
Phone: (616) 285-9090
Fax: (616) 285-7947

The provider's authorized official is Phillip L Roslaniec .
The authorized official title is Partner and has the following contact phone number (616) 285-9090.

The CLIA number assigned to this NPI record is 23D1015125 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 8/22/2020.


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
1207R00000XInternal MedicineMICHIGANYes

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
1G02811OTHERMICHIGANBLUE CROSS GROUP NUMBER

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.