JOHN WALSTRUM MD NPI 1679564975

NPI Information

NPI: 1679564975
Provider Name: JOHN WALSTRUM, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
551 LINN ST
ALLEGAN, MI
ZIP 49010
Phone: (269) 686-5800
Get Directions

John Walstrum, MD is a family medicine in Allegan, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. John Walstrum, MD NPI is 1679564975. 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:

551 LINN ST
ALLEGAN, MI
ZIP 49010-595
Phone: (269) 686-5800
Fax: (269) 686-5899

The NPI 1679564975 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/4/2005 and was last updated on 3/12/2015.

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
1	207Q00000X	Family Medicine		JW042924	MICHIGAN	Yes

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
1	20476	OTHER	MICHIGAN	HEALTH PLAN OF MI
2	P53510	OTHER	MICHIGAN	BLUE CARE NETWORK
3	JW042924	OTHER	MICHIGAN	STATE LINCENSE #
4	P00361391	OTHER	MICHIGAN	RAILROAD MEDICARE
5	01-30460	OTHER		PHP PROV #
6	080067212	OTHER		RAILROAD MEDICARE
7	P39040018	MEDICARE PIN
8	B47049	MEDICARE UPIN
9	1353542	MEDICAID	MICHIGAN
10	0800300041	OTHER	MICHIGAN	BCBS MI PROV #
11	1837425	OTHER		UNITED HEALTHCARE
12	25685	OTHER	MICHIGAN	COMMUNITY CHOICE OF MI

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

NPI Synchronization or Removal

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