Provider Demographics
NPI:1639496466
Name:PALLIATIVE CARE MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:PALLIATIVE CARE MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MALINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:231-794-8011
Mailing Address - Street 1:430 UNION AVE NE APT 209
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-5747
Mailing Address - Country:US
Mailing Address - Phone:231-794-8011
Mailing Address - Fax:231-887-4187
Practice Address - Street 1:430 UNION AVE NE APT 209
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-5747
Practice Address - Country:US
Practice Address - Phone:231-794-8011
Practice Address - Fax:231-887-4187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMB082824207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty