Provider Demographics
NPI:1013908060
Name:SEPTER, MICHAEL J (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:SEPTER
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:6735 CASCADE RD SE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-6887
Mailing Address - Country:US
Mailing Address - Phone:616-956-9400
Mailing Address - Fax:616-956-9708
Practice Address - Street 1:6735 CASCADE RD SE
Practice Address - Street 2:SUITE 300
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-6887
Practice Address - Country:US
Practice Address - Phone:616-956-9400
Practice Address - Fax:616-956-9708
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2016-04-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101009470207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMS009740OtherBCBS
MI1013908060Medicaid
MIMS009740OtherBCBS
MI0N873300001Medicare PIN