Ivey, Mark James

Ivey, Mark James is an individual health care provider with primary practice located at 17357 Van Wagoner Rd Suite 2, Spring Lake MI 49456-9702. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Ivey, Mark James can be contacted via phone (616) 847-1009.

Contact Information

Primary practice address
17357 Van Wagoner Rd Suite 2 Spring Lake MI 49456-9702
Phone: (616) 847-1009
Fax: (616) 847-1607
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 4301407127 Michigan
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 4301407127 Michigan
Allopathic & Osteopathic Physicians / Sleep Medicine 207RS0012X 4301407127 Michigan

Profile Details

NPI number 1962450981
LBN Legal business name Ivey, Mark James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Jul 19th, 2012 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962450981 NPPES
Michigan Other 1417961137 BCBS BRONSON
Michigan MEDICAID 476475710 BCBS BRONSON
Michigan MEDICAID 1962450981 BCBS BRONSON

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