BRIAN WIDEMAN


Address: 2750 E Beltline Ave Ne, Grand Rapids, MI 49525-8614
Phone: 6162677104

BRIAN WIDEMAN (NPI# 1295364008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1295364008
Entity Type Individual
Full Name BRIAN WIDEMAN
Credential DO
Practice Address 2750 E Beltline Ave Ne
Grand Rapids
MI 49525-8614
Practice Telephone 6162677104
Practice Fax Number 6162677594
Mailing Telephone 6162677104
Mailing Fax Number 6162677594
Enumeration Date 2020-04-03
Last Update Date 2020-04-03
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Office Location

Street Address 2750 E BELTLINE AVE NE
City GRAND RAPIDS
State MI
Zip Code 49525-8614

Providers in the same location

NPI Name Taxonomy Address Enumeration
1669458576 David Robert Franzblau Psychiatry & Neurology 2750 E Beltline Ave Ne, Grand Rapids, MI 49525-8614 2005-12-22
1609491000 Spectrum Health Hospitals Audiologist-Hearing Aid Fitter 2750 E Beltline Ave Ne, Grand Rapids, MI 49525-8614 2020-06-11
1740801034 Darla Wheeler Student in an Organized Health Care Education/Training Program 2750 E Beltline Ave Ne, Grand Rapids, MI 49525-8614 2020-04-28
1831719970 Lauren Offerle Student in an Organized Health Care Education/Training Program 2750 E Beltline Ave Ne, Grand Rapids, MI 49525-8614 2020-04-18
1861011611 Dania Mallick Student in an Organized Health Care Education/Training Program 2750 E Beltline Ave Ne, Grand Rapids, MI 49525-8614 2020-04-12
1720637176 Kristin Carolynn Kenny Physician Assistant 2750 E Beltline Ave Ne, Grand Rapids, MI 49525-8614 2019-09-09
1639721087 Maria Elisa Samaniego Izurieta Psychiatry & Neurology 2750 E Beltline Ave Ne, Grand Rapids, MI 49525-8614 2019-07-15
1750933107 Yao Cheng Psychiatry & Neurology 2750 E Beltline Ave Ne, Grand Rapids, MI 49525-8614 2019-07-15
1487216503 Anvita Potluri Psychiatry & Neurology 2750 E Beltline Ave Ne, Grand Rapids, MI 49525-8614 2019-06-29
1205498326 Kostika Mulo Psychiatry & Neurology 2750 E Beltline Ave Ne, Grand Rapids, MI 49525-8614 2019-06-29
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1053928507 Therapy With Nicole Pllc Community/Behavioral Health 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 2020-09-29
1184242760 Christian Healthcare Specialists, Inc. Obstetrics & Gynecology 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 2020-07-09
1174154645 Amy Vanderslik Case Manager/Care Coordinator 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 2020-02-03
1477195246 Epic Discoveries LLC Counselor 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 2019-10-14
1598228959 Kim Scherencel Lmsw Counseling Social Worker 3280 Beltline Ne, Grand Rapids, MI 49525 2019-04-11
1821558958 Mindful Trajectories Social Worker 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 2019-03-24
1104380518 Julianne Lettinga, Ma Lpc Counseling Counselor 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 2019-01-30
1396227229 Christopher Scot Doucette Social Worker 2064 Airway St Ne, Grand Rapids, MI 49525 2018-09-06
1568976017 Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry Dentist 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 2017-11-20
1407389604 Kelly Jo Crabb Social Worker 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 2017-04-05
Find all providers in zip 49525

Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1194348813 Holly Beth Myer Student in an Organized Health Care Education/Training Program 2615 3 Mile Rd Ne, Grand Rapids, MI 49525-3944 2020-05-28
1649890559 Kelsey Anne Knowles Student in an Organized Health Care Education/Training Program 2088 Watermark Dr Se, Grand Rapids, MI 49546-9012 2020-04-21
1174142285 Jeremy David Mormol Student in an Organized Health Care Education/Training Program 100 Michigan St Ne Ste 501, Grand Rapids, MI 49503-2560 2020-04-09
1417586454 Ashutosh Agrawal Student in an Organized Health Care Education/Training Program 100 Michigan St Ne # Mc46, Grand Rapids, MI 49503-2560 2020-04-02
1265061378 Heather Gladfelter Student in an Organized Health Care Education/Training Program 339 Barclay Ave Ne Ste 300, Grand Rapids, MI 49503 2020-04-02
1942858048 Kyle Brandon Avery Student in an Organized Health Care Education/Training Program 223 Prospect Ave Ne, Grand Rapids, MI 49503-5649 2019-09-01
1487209516 Kathryn Ann Pilczuk Student in an Organized Health Care Education/Training Program 333 Bridge St Nw, Grand Rapids, MI 49504-5367 2019-08-06
1831752443 Mark Pressler Student in an Organized Health Care Education/Training Program 15 Michigan St Ne, Grand Rapids, MI 49503-2509 2019-04-18
1043774177 Rebecca Elyse Mitchell Student in an Organized Health Care Education/Training Program 932 Fulton St E Apt 1, Grand Rapids, MI 49503-3565 2019-01-23
1841767712 Jordon Alexander Wurst-smith Student in an Organized Health Care Education/Training Program 44 Indiana Ave Nw, Grand Rapids, MI 49504-6369 2018-10-30
Find all providers in GRAND RAPIDS

Competitor

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City GRAND RAPIDS
Zip Code 49525

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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