Provider Demographics
NPI:1942334636
Name:HOSPITALISTS OF WEST MICHIGAN PC
Entity Type:Organization
Organization Name:HOSPITALISTS OF WEST MICHIGAN PC
Other - Org Name:INFUSION ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHAN
Authorized Official - Middle Name:JAVAN
Authorized Official - Last Name:NEDD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-954-0600
Mailing Address - Street 1:PO BOX 1682
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49501-1682
Mailing Address - Country:US
Mailing Address - Phone:616-954-0600
Mailing Address - Fax:616-954-1675
Practice Address - Street 1:3230 EAGLE PARK DR NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-7007
Practice Address - Country:US
Practice Address - Phone:616-954-0600
Practice Address - Fax:616-954-1675
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITALISTS OF WEST MICHIGAN PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-15
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy