Provider Demographics
NPI:1225267040
Name:BHUNPAEN, JENNIFER ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANN
Last Name:BHUNPAEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:25 MICHIGAN ST NE
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2515
Mailing Address - Country:US
Mailing Address - Phone:616-391-3776
Mailing Address - Fax:616-391-3130
Practice Address - Street 1:25 MICHIGAN ST NE
Practice Address - Street 2:SUITE 2200
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2515
Practice Address - Country:US
Practice Address - Phone:616-391-3776
Practice Address - Fax:616-391-3130
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301095137207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics