Provider Demographics
NPI:1750334108
Name:BIERFELDT, INGRID EERDMANS (MD)
Entity type:Individual
Prefix:MRS
First Name:INGRID
Middle Name:EERDMANS
Last Name:BIERFELDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:INGRID
Other - Middle Name:
Other - Last Name:EERDMANS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9511 WESTVIEW DR SE
Mailing Address - Street 2:
Mailing Address - City:BYRON CENTER
Mailing Address - State:MI
Mailing Address - Zip Code:49315-9324
Mailing Address - Country:US
Mailing Address - Phone:616-877-0129
Mailing Address - Fax:
Practice Address - Street 1:9511 WESTVIEW DR SE
Practice Address - Street 2:
Practice Address - City:BYRON CENTER
Practice Address - State:MI
Practice Address - Zip Code:49315-9324
Practice Address - Country:US
Practice Address - Phone:616-877-0129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010503612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI260D176250OtherBC/BS
MI4244087Medicaid
MID16083086Medicare ID - Type UnspecifiedMEDICARE
MI260D176250OtherBC/BS