Provider Demographics
NPI:1215650221
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 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:231-733-1326
Mailing Address - Fax:231-733-5212
Practice Address - Street 1:1445 SHELDON RD STE 200
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2479
Practice Address - Country:US
Practice Address - Phone:616-296-9100
Practice Address - Fax:231-733-5212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty