Provider Demographics
NPI:1538285135
Name:ARTHRITIS EDUCATION AND TREATMENT CENTER, PLLC
Entity Type:Organization
Organization Name:ARTHRITIS EDUCATION AND TREATMENT CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-459-8088
Mailing Address - Street 1:1155 E PARIS AVE SE
Mailing Address - Street 2:STE 100
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8368
Mailing Address - Country:US
Mailing Address - Phone:616-459-8088
Mailing Address - Fax:616-459-8312
Practice Address - Street 1:1155 E PARIS AVE SE
Practice Address - Street 2:STE 100
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8368
Practice Address - Country:US
Practice Address - Phone:616-459-8088
Practice Address - Fax:616-459-8312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION16600Medicare ID - Type Unspecified