Provider Demographics
NPI:1275615767
Name:MESSER, BILL J (CO)
Entity Type:Individual
Prefix:
First Name:BILL
Middle Name:J
Last Name:MESSER
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4955 E BELTLINE DR NE
Mailing Address - Street 2:SUITE C
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-1097
Mailing Address - Country:US
Mailing Address - Phone:616-447-9000
Mailing Address - Fax:616-447-9001
Practice Address - Street 1:4955 E BELTLINE DR NE
Practice Address - Street 2:SUITE C
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-1097
Practice Address - Country:US
Practice Address - Phone:616-447-9000
Practice Address - Fax:616-447-9001
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MICO3326222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1932281425Medicaid
MI51-0-D1-1643-0OtherBLUE CROSS BLUE SHEILD OF MICHIGAN
MI1932281425Medicaid