Provider Demographics
NPI:1780779298
Name:GRASMAN, ERWIN LEROY (MD)
Entity type:Individual
Prefix:DR
First Name:ERWIN
Middle Name:LEROY
Last Name:GRASMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 WHITEHALL RD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445
Mailing Address - Country:US
Mailing Address - Phone:231-744-4743
Mailing Address - Fax:231-744-4745
Practice Address - Street 1:420 WHITEHALL RD
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445
Practice Address - Country:US
Practice Address - Phone:231-744-4743
Practice Address - Fax:231-744-4745
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIEG027041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F16019OtherBCBS
MI1435450Medicaid
MI0F16019OtherPRIORITY HEALTH
MIB44912Medicare UPIN
MI1435450Medicaid