Runschke, Jurgen Gernot
Runschke, Jurgen Gernot is an individual health care provider with primary practice located at 630 Kenmoor Ave Se Ste 105 , Grand Rapids MI 49546-8626. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Runschke, Jurgen Gernot can be contacted via phone (616) 204-5698.Contact Information
Primary practice address
630 Kenmoor Ave Se Ste 105
Grand Rapids MI 49546-8626
Phone: (616) 204-5698
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 321283 | New York |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 01092546A | Indiana |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 4301080098 | Michigan |
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 4301080098 | Michigan |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 65288 | Minnesota |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 4301080098 | Michigan |
Profile Details
| NPI number | 1134166473 |
|---|---|
| LBN Legal business name | Runschke, Jurgen Gernot |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 2nd, 2006 |
| Last updated | Mar 12th, 2024 - about 8 months 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 | 1134166473 | NPPES |
| Michigan | Other | JR080098 | BCBS |
| Michigan | MEDICAID | 104806285 | BCBS |
| Michigan | MEDICAID | 104951052 | BCBS |
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