Provider Demographics
NPI:1245292549
Name:STARR, JAMES JR (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:STARR
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 BRIDGE ST NW
Mailing Address - Street 2:APT 2704
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-8702
Mailing Address - Country:US
Mailing Address - Phone:616-570-0951
Mailing Address - Fax:616-570-0951
Practice Address - Street 1:335 BRIDGE ST NW
Practice Address - Street 2:APT 2704
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504-8702
Practice Address - Country:US
Practice Address - Phone:616-570-0951
Practice Address - Fax:616-570-0951
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1738207R00000X, 208M00000X
MI5101014516207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4850283Medicaid
MIJS014516OtherBLUE CARE NETWORK
MIJS014516OtherBLUE CROSS BLUE SHIELD
MIH93721OtherPRIORITY HEALTH
MIN27530027Medicare PIN