Provider Demographics
NPI:1629558978
Name:NORTHVIEW HEALTH SPECIALISTS, PLLC
Entity type:Organization
Organization Name:NORTHVIEW HEALTH SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:616-889-2812
Mailing Address - Street 1:1765 3 MILE RD NE UNIT 150319
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49515-5014
Mailing Address - Country:US
Mailing Address - Phone:616-272-3533
Mailing Address - Fax:616-259-4839
Practice Address - Street 1:1765 3 MILE RD NE UNIT 150319
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49515-5014
Practice Address - Country:US
Practice Address - Phone:616-272-3533
Practice Address - Fax:616-259-4839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty