Provider Demographics
NPI:1932281425
Name:MESSER ORTHOPEDICS PLAINFIELD LLC
Entity Type:Organization
Organization Name:MESSER ORTHOPEDICS PLAINFIELD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MESSER
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:248-549-2360
Mailing Address - Street 1:PO BOX 2140
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48068-2140
Mailing Address - Country:US
Mailing Address - Phone:248-549-2360
Mailing Address - Fax:
Practice Address - Street 1:4550 PLAINFIELD AVE NE
Practice Address - Street 2:SUITE A
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-1642
Practice Address - Country:US
Practice Address - Phone:616-447-9025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICO3226222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI51-0-D1-1643-0OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI1932281425Medicaid
MI1932281425Medicaid