Provider Demographics
NPI:1396804571
Name:GRAND RAPIDS ASSOCIATED INTERNISTS, P.C.
Entity type:Organization
Organization Name:GRAND RAPIDS ASSOCIATED INTERNISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:KROPEWNICKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-459-0292
Mailing Address - Street 1:1900 WEALTHY ST SE
Mailing Address - Street 2:SUITE 375
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-2969
Mailing Address - Country:US
Mailing Address - Phone:616-459-0292
Mailing Address - Fax:616-459-3922
Practice Address - Street 1:1900 WEALTHY ST SE
Practice Address - Street 2:SUITE 375
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-2969
Practice Address - Country:US
Practice Address - Phone:616-459-0292
Practice Address - Fax:616-459-3922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207R00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0D16345OtherBCBS GROUP NUMBER
MICA3250OtherRAILROAD MEDICARE GROUP
MICA3250OtherRAILROAD MEDICARE GROUP
MI0M04840Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER