Provider Demographics
NPI:1659308567
Name:MASLOW, JOEL NEAL (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:NEAL
Last Name:MASLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 MICHIGAN ST NE
Mailing Address - Street 2:MC845
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:616-486-6790
Mailing Address - Fax:616-486-6702
Practice Address - Street 1:25 MICHIGAN ST NE
Practice Address - Street 2:MC038
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2515
Practice Address - Country:US
Practice Address - Phone:616-391-3050
Practice Address - Fax:616-391-9150
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2012-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD034344E207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017533200002Medicaid
PA0017533200002Medicaid
PA027551Medicare ID - Type Unspecified