Maria E Dimusto-poortenga
MD | Pediatric Neonatal-Perinatal Medicine | Female
Maria E Dimusto-poortenga, MD is a Grand Rapids, Michigan based Pediatric doctor with medical specialization in
Pediatric Neonatal-Perinatal Medicine. Maria E Dimusto-poortenga is also known as
Mariel Elizabeth Dimustopoortenga.
Current practice location of Maria E Dimusto-poortenga is
200 Jefferson Ave Se, Nicu, Grand Rapids, Michigan - 49503-4502. She can be contacted on phone at
616-752-6554.
Maria E Dimusto-poortenga is a sole proprietor of her business.
NPI number (Unique professional ID) for Maria E Dimusto-poortenga is
1013940980 which was assigned by NPPES on 07 Jul, 2006 and it was last updated on 28 Feb, 2022.
Maria E Dimusto-poortenga license number is
4301068818 for Pediatrics Neonatal-Perinatal Medicine (2080N0001X) in Michigan.
Maria E Dimusto-poortenga is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
Complete Profile:
Maria E Dimusto-poortenga basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Neonatal-Perinatal Medicine |
|---|
| Provider Name : | Maria E Dimusto-poortenga |
|---|
| Other Name : | Mariel Elizabeth Dimustopoortenga |
|---|
| Credential : | MD |
|---|
| Gender : | Female |
|---|
Business Address:
Maria E Dimusto-poortenga address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 200 Jefferson Ave Se, Nicu
Grand Rapids, MI, 49503-4502
United States |
|---|
| Phone Number : | 616-752-6554 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1013940980 |
|---|
| NPI Entity Type : | Individual |
|---|
| First Enrolment Date : | 07 Jul, 2006 |
|---|
| Last Updated On : | 28 Feb, 2022 |
|---|
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Maria E Dimusto-poortenga are as mentioned. Primary taxonomy code for Maria E Dimusto-poortenga, MD is
2080N0001X (Pediatrics Neonatal-Perinatal Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | No | 4301068818 | MI |
| 2080N0001X | Pediatrics Neonatal-Perinatal Medicine | No | 1013940980 | MI |
| 2080N0001X | Pediatrics Neonatal-Perinatal Medicine | No | ME141884 | FL |
| 2080N0001X | Pediatrics Neonatal-Perinatal Medicine | Yes | 4301068818 | MI |
Legacy Identifiers:
Other legacy medical identifiers of Maria E Dimusto-poortenga such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 4120849 | MEDICAID | MI | |
| 4877886 | MEDICAID | MI | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 245 State St Se
Grand Rapids, MI, 49503-4328
United States |
|---|
| Fax Number : | 616-913-1818 |
|---|
Business Location:
Patients can refer following map for directions to
Maria E Dimusto-poortenga practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.