Provider Demographics
NPI:1215906219
Name:METROPOLITAN ANESTHESIA ASSOCIATES, P.C.
Entity type:Organization
Organization Name:METROPOLITAN ANESTHESIA ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:VANLAAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-235-4800
Mailing Address - Street 1:96 MONROE CTR NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2905
Mailing Address - Country:US
Mailing Address - Phone:616-235-4800
Mailing Address - Fax:616-235-1212
Practice Address - Street 1:1919 BOSTON ST SE
Practice Address - Street 2:METROPOLITAN HOSPITAL
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-4160
Practice Address - Country:US
Practice Address - Phone:616-808-3944
Practice Address - Fax:616-808-3948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICE1952OtherRAILROAD MEDICARE GRP#
MICE1952OtherRAILROAD MEDICARE GRP#
MI0M58670Medicare ID - Type UnspecifiedMEDICARE CRNA GRP#