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WEST MICHIGAN FAMILY PRACTICE PC NPI 1639382211


NPI Information

NPI: 1639382211
Provider Name: WEST MICHIGAN FAMILY PRACTICE, PC

Doing Business As: ADA VILLAGE MEDICAL

Classification: Emergency Medicine - 207P00000X
Entity Type: Organization
Address:
877 FOREST HILL AVE SE
SUITE C
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 954-0402
Get Directions

WEST MICHIGAN FAMILY PRACTICE, PC is an emergency medicine in Grand Rapids, MI. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. WEST MICHIGAN FAMILY PRACTICE, PC NPI is 1639382211. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Ada Village Medical.

The provider's business location address is:

877 FOREST HILL AVE SE
SUITE C
GRAND RAPIDS, MI
ZIP 49546-380
Phone: (616) 954-0402
Fax: (616) 954-0404

The provider's authorized official is Daryl M Lawrence-friedl .
The authorized official title is D.o. and has the following contact phone number (616) 954-0402.

The enumeration date for this NPI number is 5/8/2007 and was last updated on 10/22/2011.


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
1207Q00000XFamily Medicine5101010305MICHIGANNo
2207P00000XEmergency Medicine5101010305MICHIGANYes

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
10P24140MEDICARE PINMICHIGAN
20D12216OTHERMICHIGANBCBS
3DH2054OTHERMICHIGANRR MEDICARE
41639382211MEDICAIDMICHIGAN

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: 11/14/2023

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