DR. MICHAEL SHAWN BOLAN (NPI# 1659488807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659488807 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL SHAWN BOLAN |
| Credential | D.O. |
| Practice Address |
2272 32nd St Se Kentwood MI 49508-1509 |
| Practice Telephone | 6162470399 |
| Practice Fax Number | 6162470499 |
| Mailing Telephone | 6162470399 |
| Mailing Fax Number | 6162470499 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2014-08-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101009303 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609379726 | Michael Bolan | Pharmacist | 4076 Neely Road, Fort Wainwright, AK 99709 | 2018-03-15 |
| 1457625246 | Michael Bolan | Social Worker | 21751 Ecorse Rd, Taylor, MI 48180-1846 | 2012-02-27 |
| Street Address |
2272 32ND ST SE |
| City | KENTWOOD |
| State | MI |
| Zip Code | 49508-1509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012367 | Jenna Brianne Labrecque | Social Worker | 2013 East Castle Dr, Suite B, Kentwood, MI 49508 | 2020-10-27 |
| 1881208809 | Morgan Paige Ballmann | Physical Therapy Assistant | 4150 Kalamazoo Ave. Se, Grand Rapids, MI 49508 | 2020-09-08 |
| 1699385740 | Jodie Lynn Robertson | Prosthetist | 3720 Eastern Se, Grand Rapids, MI 49508 | 2020-08-04 |
| 1003460874 | Derm Institute of West Michigan Plc | Dermatology | 6750 Kalamazoo Ave, Suites C & D, Grand Rapids, MI 49508 | 2019-07-30 |
| 1255801833 | Ikeia Tynika Hill | Licensed Practical Nurse | 1627 Lotus, Grand Rapids, MI 49508 | 2018-11-27 |
| 1326556838 | Araceli Contreras-hernandez | Behavior Technician | 3566 Eastern Ave. Se, Kentwood, MI 49508 | 2018-01-18 |
| 1881102788 | A Grand Rapids Senior Social Exchange and Adult Day Center | In Home Supportive Care | 3212 Eastern Ave Se, Grand Rapids, MI 49508 | 2018-01-14 |
| 1952827107 | Nupoint Services LLC | Clinic/Center | 1620 44th Street Se, Grand Rapids, MI 49508 | 2017-08-19 |
| 1710427695 | Embracing Life Afc | Custodial Care Facility | 1405 Forrester St S.e., Grand Rapids, MI 49508 | 2017-02-27 |
| 1083162838 | Katherine Berenice Campoverde Arevalo | Technician, Other | 1157 Billigs Ct Se, Ap# 1a, Grand Rapids, MI 49508 | 2016-09-21 |
| Find all providers in zip 49508 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508821539 | Norman A Weber | Family Medicine | 1676 Viewpond Dr Se, Kentwood, MI 49508-4994 | 2006-04-20 |
| 1336143965 | Eric C Bouwens | Family Medicine | 1900 44th St Se, Kentwood, MI 49508-5008 | 2005-06-10 |
| 1467456129 | Marie Vander Linde | Family Medicine | 2080 44th St Se, Kentwood, MI 49508-5299 | 2005-06-10 |
| 1265436836 | George S Bruins | Family Medicine | 4600 Breton Rd Se, Ste 102, Kentwood, MI 49508-5220 | 2005-06-10 |
| 1174973226 | Naila Kovacevic | Family Medicine | 4600 Breton Rd Se Ste 102, Kentwood, MI 49508-5220 | 2016-06-20 |
| 1831513449 | West Michigan Family Health PC | Family Medicine | 2120 43rd St Se, Suite 200, Kentwood, MI 49508-3772 | 2014-02-18 |
| 1487093860 | Jason Eric Essenberg | Family Medicine | 4600 Breton Rd Se, Suite 102, Kentwood, MI 49508 | 2013-06-19 |
| 1609215086 | John Devlin Sprague | Family Medicine | 4600 Breton Rd Se, Suite 102, Kentwood, MI 49508-5262 | 2013-06-19 |
| 1457790149 | Katherine Burton | Family Medicine | 2080 44th St Se, Kentwood, MI 49508-5299 | 2013-06-17 |
| 1053623074 | Spectrum Health Primary Care Partners | Family Medicine | 4600 Breton Rd Se, Suite 102, Kentwood, MI 49508-5262 | 2010-07-07 |
| Find all providers in KENTWOOD | ||||
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| 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.