GEOFFREY R DETOLVE MD NPI 1184604795

NPI Information

  • NPI: 1184604795
  • Provider Name: GEOFFREY R DETOLVE, MD
  • Classification: Pediatrics - 208000000X
  • Entity Type: Individual
  • Address: 601 JOHN ST
    SUITE E352
    KALAMAZOO, MI
    ZIP 49007
  • Phone: (269) 341-8986

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NPI Details

Geoffrey R Detolve, MD is a pediatrics in Kalamazoo, MI. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Geoffrey R Detolve, MD NPI is 1184604795. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

601 JOHN ST
SUITE E352
KALAMAZOO, MI
ZIP 49007-341
Phone: (269) 341-8986
Fax: (269) 341-6236

The enumeration date for this NPI number is 1/19/2006 and was last updated on 11/17/2014.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics4301064382MICHIGANYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C97618216MEDICARE PINMICHIGAN
2D14585MEDICARE UPIN
31417961137OTHERMICHIGANBCBSM - BMH TAX ID# 38-1359087
41184604795MEDICAIDMICHIGAN
50M20520031MEDICARE PINMICHIGAN
64385657MEDICAIDMICHIGAN

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: 3/30/2025

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