Organization · Type 2 NPI

Address Healthcare of Michigan PLLC

Internal Medicine Physician · Grand Rapids, MI

NPI number 1043075294 Active

Practice location

600 Monroe Avenue NW, Ste 104
Grand Rapids, MI 49503-1470

Call (616) 366-4234 Map

Fax (855) 548-4481

Mailing address

3940 Peninsular Drive SE, Ste 230
Grand Rapids, MI 49546-2442

Specialties and licenses

Taxonomy	Code	License
Optometrist	152W00000X	None listed
Internal Medicine Physician Primary	207R00000X	None listed
Hospice and Palliative Medicine (Internal Medicine) Physician	207RH0002X	None listed
Geriatric Psychiatry Physician	2084P0805X	None listed
Foot & Ankle Surgery Podiatrist	213ES0103X	None listed
Adult Health Nurse Practitioner	363LA2200X	None listed

Internal Medicine Physician: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medi…

2 other providers at this address

Other internal medicine physician providers in Grand Rapids

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NPI record

NPI: 1043075294
Entity type: Organization (Type 2)
Issued: Feb 16, 2024
Last updated: May 5, 2025
Status: Active

Other names

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Address Healthcare · doing business as
Address Healthcare · doing business as
Address Healthcare of Michigan · doing business as

Authorized official

Jeffrey L Wacksman
Authorized Official
(616) 366-4234

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1043075294

Address Healthcare of Michigan PLLC's National Provider Identifier is 1043075294, issued on Feb 16, 2024. The primary taxonomy on file is Internal Medicine Physician (207R00000X), and the practice location is in Grand Rapids, MI. The record was last updated on May 5, 2025.