Provider Demographics
NPI:1619960598
Name:HUVER, AMANDA MELISSA (DO)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MELISSA
Last Name:HUVER
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Gender:F
Credentials:DO
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Mailing Address - Street 1:2249 WEALTHY ST SE
Mailing Address - Street 2:STE 202
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-3052
Mailing Address - Country:US
Mailing Address - Phone:248-952-1601
Mailing Address - Fax:248-952-1614
Practice Address - Street 1:3355 EAGLE PARK DR NE
Practice Address - Street 2:STE103
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-7004
Practice Address - Country:US
Practice Address - Phone:616-942-7400
Practice Address - Fax:616-942-7405
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2016-10-07
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Provider Licenses
StateLicense IDTaxonomies
MI5101010570207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1827384OtherUNITED HEALTH
MI4325843OtherAETNA
ID1154130014OtherBLUE CROSS OF MI
MI4341483Medicaid
F42232Medicare UPIN
MI1827384OtherUNITED HEALTH