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Ferris State University

Organization Active NPI Family Medicine Physician · Big Rapids, MI

NPI 1871707992 · NPPES record last updated Jun 16, 2008

Key facts

NPI
1871707992
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
4301040919 (MI)
Legal business name
FERRIS STATE UNIVERSITY
Practice address
1019 Campus Dr
Big Rapids, MI 49307-2280
Phone
(231) 591-2614
Fax
(231) 591-5970
NPI assigned
May 9, 2007
Organization subpart
No

Authorized official

Name
Dr. R Paul Sullivan, PHD
Title
Director
Phone
(231) 591-2616

Corporate family (same tax ID) 8

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Ferris State Col of Opt (9 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X 4301040919 MI Yes

Addresses

Primary practice location

1019 Campus Dr
Big Rapids, MI 49307-2280

Mailing address

1019 Campus Dr
Big Rapids, MI 49307-2280
Phone (231) 591-2614

Other identifiers

IdentifierTypeStateIssuer
0E46000OtherMIBLUE SHIELD

Other names

  • Birkam Health Center Doing business as

Other providers in Big Rapids, MI

All providers in Big Rapids, MI · Family Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.