MICHAEL J BULTJE (NPI# 1144224882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144224882 |
| Entity Type | Individual |
| Full Name | MICHAEL J BULTJE |
| Credential | DO |
| Practice Address |
2093 Health Dr Sw Ste 200 Wyoming MI 49519-9691 |
| Practice Telephone | 6164593158 |
| Practice Fax Number | 6168192222 |
| Mailing Telephone | 6164593158 |
| Mailing Fax Number | 6168192222 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2016-06-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 5101014160 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4426277 | 05 | |
| MI | IRS TAX ID # THRU NEW EMPLOYER EFFECTIVE 6/30/09 | 38-2145264 | 01 |
| Street Address |
2093 HEALTH DR SW STE 200 |
| City | WYOMING |
| State | MI |
| Zip Code | 49519-9691 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275537011 | Thomas V Bilisko | Internal Medicine | 2093 Health Dr Sw, Ste 200, Wyoming, MI 49519-9691 | 2005-06-09 |
| 1134509532 | Rehabilitation Therapy Associates | Clinic/Center | 2093 Health Dr Sw, Suite 201, Wyoming, MI 49519-9691 | 2015-06-02 |
| 1619374725 | Sharon Eileen Possehl | Nurse Practitioner | 2093 Health Dr Sw, Suite 202, Wyoming, MI 49519-9691 | 2014-12-04 |
| 1518243278 | Emily Suzanne Haligowski | Nurse Practitioner | 2093 Health Dr Sw, Suite 200, Wyoming, MI 49519-9691 | 2011-10-26 |
| 1851600803 | Cheryl Lynn Kruithof | Nurse Practitioner | 2093 Health Dr Sw, Suite 302, Wyoming, MI 49519-9691 | 2010-09-24 |
| 1396050118 | Armita Ghoddousi | Internal Medicine | 2093 Health Dr Sw, Wyoming, MI 49519-9691 | 2010-08-17 |
| 1851544555 | Victory Institute for Weight Management | Behavioral Analyst | 2093 Health Dr Sw, Suite 302, Wyoming, MI 49519-9691 | 2008-10-28 |
| 1982819611 | John Timothy Morris | Surgery | 2093 Health Dr Sw, Suite 300, Wyoming, MI 49519-9691 | 2007-05-14 |
| 1386791515 | Jeannie Wilcox | Physician Assistant | 2093 Health Dr Sw, #101, Wyoming, MI 49519-9691 | 2007-01-03 |
| 1477619997 | Bruce H Vermeer | Clinical Neuropsychologist | 2093 Health Dr Sw, Suite 200, Wyoming, MI 49519-9691 | 2006-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609364009 | Alexandra K Hylen | Dentist | 4489 Byron Center Ave Sw Ste A, Wyoming, MI 49519 | 2018-05-01 |
| 1962925685 | Nicole Lee Kolasa | Rehabilitation Counselor | 2038 Melvin St. Sw, Wyoming, MI 49519 | 2017-07-25 |
| 1720534472 | Michael Ash | Rehabilitation Practitioner | 1870 36th Street, Wyoming, MI 49519 | 2016-08-31 |
| 1891248993 | Kayleigh Saucier | Family Medicine | 5900 Byron Center Avenue Se, Wyoming, MI 49519 | 2016-07-26 |
| 1093112799 | Wmro LLC | Radiology | 5950 Metro Way, Wyoming, MI 49519 | 2014-11-24 |
| 1033547658 | Maranda Catherine Gary | Nurse Practitioner | 2122 Health Drive, Wyoming, MI 49519 | 2013-10-16 |
| 1144657800 | Diana Ro | Psychologist | 4211 Parkway Place Sw, #100, Wyoming, MI 49519 | 2013-09-26 |
| 1386077873 | Lindsey Elizabeth Chorney | Nurse Practitioner | 2122 Health Drive Sw, Suite 133, Wyoming, MI 49519 | 2013-08-20 |
| 1124377163 | Vision and Sensory Center of Michigan LLC | Optometrist | 4467 Byron Center Ave., Wyoming, MI 49519 | 2012-09-06 |
| 1881940203 | Judah | Durable Medical Equipment & Medical Supplies | 2975 Waterchase Way Sw Suite 307, Wyoming, MI 49519 | 2012-08-03 |
| Find all providers in zip 49519 | ||||
| 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 |
|---|---|---|---|---|
| 1891248993 | Kayleigh Saucier | Family Medicine | 5900 Byron Center Avenue Se, Wyoming, MI 49519 | 2016-07-26 |
| 1710368782 | Tracie Medrano- Smith | Family Medicine | 4174 56th St Sw, Wyoming, MI 49418 | 2015-06-15 |
| 1174863930 | Tom Cohen | Family Medicine | 105 Church Rd, Rd#3, Wyoming, PA 18644-9329 | 2013-02-15 |
| 1235225293 | Richard J Stang | Family Medicine | 3011 Sandy Ct Sw, Wyoming, MI 49418-8736 | 2006-10-05 |
| 1528168986 | Sunforest Family Medicine, Plc | Family Medicine | 3020 Waterchase Way Sw, Apt. 304, Wyoming, MI 49519-5997 | 2006-09-25 |
| 1609801570 | Natalie D Williams | Family Medicine | 3020 Wasterchase Way, Apt 304, Wyoming, MI 49519 | 2006-07-11 |
| 1912950155 | Elizabeth A Boessenkool | Family Medicine | 950 36th St Sw, Wyoming, MI 49509-3587 | 2006-05-18 |
| 1760430524 | Remigijus Satkauskas | Family Medicine | 101 S Galena Ave, Wyoming, IL 61491-1470 | 2006-05-04 |
| 1598735961 | Medical Associates of Maquoketa PC | Family Medicine | 307 E Webster St, Wyoming, IA 52362 | 2006-01-26 |
| 1619973559 | Toni Jo Parmelee | Family Medicine | 214 Wyoming Ave, Wyoming, PA 18644-1619 | 2005-06-24 |
| Find all providers in WYOMING | ||||
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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.