Provider Demographics
NPI:1588731087
Name:GASTROENTEROLOGY ASSOCIATES OF WESTERN MICHIGAN PLC
Entity type:Organization
Organization Name:GASTROENTEROLOGY ASSOCIATES OF WESTERN MICHIGAN PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COATES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:616-450-2765
Mailing Address - Street 1:2093 HEALTH DR SW STE 201
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-9691
Mailing Address - Country:US
Mailing Address - Phone:616-328-5350
Mailing Address - Fax:616-452-4142
Practice Address - Street 1:2093 HEALTH DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519
Practice Address - Country:US
Practice Address - Phone:616-452-7099
Practice Address - Fax:616-452-4142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1134509532Medicaid
MI1093116048Medicaid
MI1588731087Medicaid