Provider Demographics
NPI:1972857720
Name:KUIK, MICHAEL (BA)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:KUIK
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 WEST GREEN STREET
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-1723
Mailing Address - Country:US
Mailing Address - Phone:269-948-8041
Mailing Address - Fax:269-948-9319
Practice Address - Street 1:915 WEST GREEN STREET
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-1723
Practice Address - Country:US
Practice Address - Phone:269-948-8041
Practice Address - Fax:269-948-9319
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator