Dr. Gary David Poelman
General Practice Physician Emergency Medical Services Family Doctor - Geriatric Medicine
3355 Eagle Park Dr Ne Ste103
Grand Rapids
, Michigan 49525-7004
Dr. Gary David Poelman
General Practice Physician Emergency Medical Services Family Doctor - Geriatric Medicine
3355 Eagle Park Dr Ne Ste103
Grand Rapids
, Michigan 49525-7004
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About
Features
Specialties
- Emergency Medical Services
- Family Doctor - Geriatric Medicine
- General Practice Physician
Languages spoken
- English
Location
First Address
- Dr. Gary David Poelman
- 3713 Norton Hills Rd
- Norton Shores, MI
- Zip : 49441-4469
- Phone :
Second Address
- Dr. Gary David Poelman
- 3355 Eagle Park Dr Ne Ste103
- Grand Rapids, MI
- Zip : 49525-7004
- Phone : (616) 942-7400
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207PE0004X | Emergency Medical Services | GP043454 | MI |
| N | 207QG0300X | Family Doctor - Geriatric Medicine | GP043454 | MI |
| Y | 208D00000X | General Practice Physician | GP043454 | MI |
National Provider Identifier
| NPI | 1336261395 |
|---|---|
| Provider Name | Dr. Gary David Poelman |
| First Address | Norton Shores, MI 49441-4469 |
| Second Address | Grand Rapids, MI 49525-7004 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/04/2007 |
| Last Update Date | 14/09/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0107001012 | BCBS (01) | |
| 117141PC | CCHMO,CCPPO,MERCY (01) | |
| 152750 | PHCS (01) | |
| 40099285 | AETNA (01) | |
| B43739 | (02) | |
| B43739 | PRIORITY HEALTH (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.