Provider Demographics
NPI:1194451567
Name:ORTHOPAEDIC ASSOCIATES OF MUSKEGON, PC
Entity type:Organization
Organization Name:ORTHOPAEDIC ASSOCIATES OF MUSKEGON, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SYSTEMS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:PODEIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:231-830-2748
Mailing Address - Street 1:1400 MERCY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1833
Mailing Address - Country:US
Mailing Address - Phone:231-830-2748
Mailing Address - Fax:231-733-5212
Practice Address - Street 1:1400 MERCY DR STE 100
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1833
Practice Address - Country:US
Practice Address - Phone:231-830-2748
Practice Address - Fax:231-733-5212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty