Provider Demographics
NPI:1558568204
Name:KNOLLCRESTOB-GYN ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:KNOLLCRESTOB-GYN ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:FINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-942-1300
Mailing Address - Street 1:3300 BURTON ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-4398
Mailing Address - Country:US
Mailing Address - Phone:616-942-1300
Mailing Address - Fax:616-942-7362
Practice Address - Street 1:3300 BURTON ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-4398
Practice Address - Country:US
Practice Address - Phone:616-942-1300
Practice Address - Fax:616-942-7362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0D16306Medicare ID - Type Unspecified