Provider Demographics
NPI:1972552628
Name:DROSTE, PATRICK JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JOSEPH
Last Name:DROSTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5050 CASCADE RD SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-3725
Mailing Address - Country:US
Mailing Address - Phone:616-957-0866
Mailing Address - Fax:616-956-0281
Practice Address - Street 1:5050 CASCADE RD SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3725
Practice Address - Country:US
Practice Address - Phone:616-957-0866
Practice Address - Fax:616-956-0281
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI047600207W00000X
MI4301047600207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus SpecialistGroup - Single Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI180040367OtherRETIRED RAILROAD
MI1804102032OtherBLUE CHOICE
MI2636622Medicaid
MI2636622OtherCHILDREN SPECIAL HEALTH
MI700000215OtherPRIORITY HEALTH HMO
MIM015190OtherCHAMPUS
MI1804102032OtherBLUE CARE NETWORK
MI700000215OtherPRIORITY HEALTH MEDICARE
MI1804102032OtherBLUE CROSS BLUE SHIELD
MI700000215OtherPRIORITY HEALTH MEDICAID
MI180040367OtherRETIRED RAILROAD
MI2636622Medicaid