12TH STREET PLLC NPI 1790470409

NPI Details

12TH STREET PLLC is an internal medicine in Wayland, 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. 12TH STREET PLLC NPI is 1790470409. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As 12th Street Internal Medicine And Pediatrics.

The provider's business location address is:

3587 12TH ST
WAYLAND, MI
ZIP 49348-569
Phone: (616) 648-4933

The provider's authorized official is Joel Veldhouse .
The authorized official title is Physician Owner and has the following contact phone number (616) 648-4933.

The CLIA number assigned to this NPI record is 23D2283672 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/7/2023 and was last updated on 8/15/2023.

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: