Axtell, Richard A
Axtell, Richard A is an individual health care provider with primary practice located at 100 Michigan St Ne Mc 249, Grand Rapids MI 49503-2560. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as his primary health care specialty. Axtell, Richard A can be contacted via phone (616) 267-1925.Contact Information
Primary practice address
100 Michigan St Ne Mc 249
Grand Rapids MI 49503-2560
Phone: (616) 267-1925
Fax: (616) 267-1005
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | 4301048203 | Michigan |
Profile Details
| NPI number | 1932170065 |
|---|---|
| LBN Legal business name | Axtell, Richard A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 27th, 2006 |
| Last updated | Apr 3rd, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932170065 | NPPES |
| Michigan | Other | 1104134811 | BCBSM |
| Michigan | MEDICAID | 2841427 | BCBSM |
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