Provider Demographics
NPI:1649215880
Name:HEALTHQUEST SURGICAL ASSOCIATES PLC
Entity Type:Organization
Organization Name:HEALTHQUEST SURGICAL ASSOCIATES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:H
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-458-1200
Mailing Address - Street 1:1900 WEALTHY ST SE
Mailing Address - Street 2:SUITE 180
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-2969
Mailing Address - Country:US
Mailing Address - Phone:616-458-1200
Mailing Address - Fax:616-459-0199
Practice Address - Street 1:1900 WEALTHY ST SE
Practice Address - Street 2:SUITE 180
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-2969
Practice Address - Country:US
Practice Address - Phone:616-458-1200
Practice Address - Fax:616-459-0199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M56400Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER