James Edward Green in Grand Rapids - Physician Assistant
James Edward Green - NPI 1285747378
James Edward Green is a Physician Assistant in Grand Rapids, Michigan. James Edward Green practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for James Edward Green is 1285747378. The last update date is 2013-03-04.
James Edward Green's current location address is 3333 Evergreen Dr Ne, Grand Rapids, Michigan. You can contact this provider via phone number 6163644200 and fax number 6163647347. The mailing address for James Edward Green is 3333 Evergreen Dr Ne, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
Provider Name | James Edward Green |
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Address | 3333 Evergreen Dr Ne, Grand Rapids, Michigan |
Phone Number | 6163644200 |
Fax Number | 6163647347 |
Sole Proprietor | N |
Credentials | AA, PA |
NPI Number Detail
NPI Number | 1285747378 |
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Provider Enumeration Date | 2006-08-16 |
Last Updated Date | 2013-03-04 |
Provider Mailing Address Detail
Address | 3333 Evergreen Dr Ne |
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City | Grand Rapids |
State | Michigan (MI) |
Post Code | 495259493 |
Phone Number | 6163644200 |
Fax Number | 6163647347 |
Provider's Primary Taxonomy Detail
Speciality | Physician Assistant |
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Taxonomy | 363A00000X |
Licence No | 5601001816 |
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
P00343185 | MI | RAILROAD MEDICARE PIN | |
M73860-008 | MI | MEDICARE | |
1598712390 | MI | GROUP NPI |
Post Comment/ Review Below
Could you please provide the complete street address where James Edward Green is physically located?
The James Edward Green is physically situated at the following address: 3333 Evergreen Dr Ne, Grand Rapids, MI, 495259493.
When did the James Edward Green receive its 1285747378?
The James Edward Green was issued its 1285747378 on 2006-08-16, which is the date when the organization was assigned this unique identifier.
On what date did the James Edward Green receive its 1285747378 assignment from the Centers for Medicare & Medicaid Services?
The James Edward Green was assigned its 1285747378 by the Centers for Medicare & Medicaid Services on 2006-08-16.
As of what date were the James Edward Green's details last updated?
The information pertaining to the James Edward Green, including its address, specialty, and other details, was most recently updated on 2013-03-04.
As of what date were the details related to James Edward Green most recently updated or revised?
The information pertaining to James Edward Green, including its address, specialty, and other relevant details, was last updated or revised on 2013-03-04.