Madura, Michael James

Madura, Michael James is an individual health care provider with primary practice located at 1900 Wealthy St Se Ste 150, Grand Rapids MI 49506-2969. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Madura, Michael James can be contacted via phone (616) 459-3158.

Contact Information

Primary practice address
1900 Wealthy St Se Ste 150 Grand Rapids MI 49506-2969
Phone: (616) 459-3158
Fax: (616) 459-4714
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 4301043486 Michigan

Profile Details

NPI number 1497862437
LBN Legal business name Madura, Michael James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2006
Last updated Jun 22nd, 2010 - about 14 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 1497862437 NPPES
Michigan Other 1004100351 BCBS OF MICHIGAN
Michigan MEDICAID 3318794 BCBS OF MICHIGAN
Michigan Other 38-2145264 BCBS OF MICHIGAN

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