Provider Demographics
NPI:1639390875
Name:ZEELAND FAMILY MEDICINE, PC
Entity Type:Organization
Organization Name:ZEELAND FAMILY MEDICINE, PC
Other - Org Name:MARK N FOLKENING, MD, PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-741-9720
Mailing Address - Street 1:400 S STATE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-2067
Mailing Address - Country:US
Mailing Address - Phone:616-741-9720
Mailing Address - Fax:616-741-9725
Practice Address - Street 1:400 S STATE ST STE 200
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-2067
Practice Address - Country:US
Practice Address - Phone:616-741-9720
Practice Address - Fax:616-741-9725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B43341Medicare UPIN
MIP 14550001Medicare ID - Type Unspecified