SUSANNE PETTIGREW PA-C NPI 1780686550

NPI Information

NPI: 1780686550
Provider Name: SUSANNE PETTIGREW, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
145 MICHIGAN ST NE STE 4400
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 486-6333
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Susanne Pettigrew, PA-C is a medical physician assistant in Grand Rapids, MI. Susanne Pettigrew, PA-C NPI is 1780686550. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

145 MICHIGAN ST NE STE 4400
GRAND RAPIDS, MI
ZIP 49503-564
Phone: (616) 486-6333

The NPI 1780686550 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 8/11/2005 and was last updated on 3/30/2020.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	5601001592	MICHIGAN	Yes

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

NPI Synchronization or Removal

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