Edward Tanudjaja
Internist
1500 E Sherman Blvd
Muskegon
, Michigan 49444-1849
(925) 437-8559
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About
Features
Language(s) Spoken
English
Ethnic Identity
White / Caucasian
Specialties
- Internist
Languages spoken
- English
Location
First Address
- Edward Tanudjaja
- 18379 Woodland Ridge Dr Apt 6
- Spring Lake, MI
- Zip : 49456-8924
- Phone : (925) 437-8559
Second Address
- Edward Tanudjaja
- 1500 E Sherman Blvd
- Muskegon, MI
- Zip : 49444-1849
- Phone : (231) 672-2000
Reviews
FAQs
Where did Edward Tanudjaja attend graduate school?
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Where did Edward Tanudjaja do his residency?
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Where did Edward Tanudjaja do his fellowship?
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Is Edward Tanudjaja board certified?
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What type of doctor is Edward Tanudjaja
Internist
In what state does Edward Tanudjaja practice in?
Michigan
Where is Edward Tanudjaja ’s practice located?
1500 E Sherman Blvd , Muskegon, Michigan, 49444-1849
What is Edward Tanudjaja ’s gender?
Male
Is Edward Tanudjaja a sole practitioner?
No
Is Edward Tanudjaja accepting new patients?
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What languages does Edward Tanudjaja speak?
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Does Edward Tanudjaja accept insurance?
Yes, Edward Tanudjaja accepts insurance
Does Edward Tanudjaja offers telemedicine?
Edward Tanudjaja has not indicated if he offers telemedicine
What is Edward Tanudjaja ’s professional license number?
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What is Edward Tanudjaja ’s NPI number?
1003499229
Does Edward Tanudjaja have any license restrictions?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207R00000X | Internist | 5151015204 | MI |
| Y | 111NI0900X | Internist | 5151015204 | MI |
National Provider Identifier
| NPI | 1003499229 |
|---|---|
| Provider Name | Edward Tanudjaja |
| First Address | Spring Lake, MI 49456-8924 |
| Second Address | Muskegon, MI 49444-1849 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/05/2021 |
| Last Update Date | 05/05/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI. The entity type codes are:
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)
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?
Subparts are the components and separate physical locations of organization health care providers.
Subpart examples include: Hospital components include outpatient departments, surgical centers,
psychiatric units, and laboratories. These components are often separately licensed or certified by
States and may exist at physical locations other than that of the hospital of which they are a
component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if
an individual) or other name by which the organization provider is or has been known. The code
identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date
The date that a NPI record was last updated or changed
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPls the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the PI application or to officially change data for a health care provider.