Provider Demographics
NPI:1598996480
Name:GRAND RAPIDS MEDICAL EDUCATION AND RESEARCH NUMBER
Entity type:Organization
Organization Name:GRAND RAPIDS MEDICAL EDUCATION AND RESEARCH NUMBER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT/ INTERN
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-449-9661
Mailing Address - Street 1:5 PALMER ST NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-4625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 MICHIGAN ST NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2560
Practice Address - Country:US
Practice Address - Phone:616-391-3670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2009-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301094849282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren