Most Relevant Information
Provider Data
| NPI Number: | 1003816224 |
| Provider Name: | TAMMY BORN HUIZENGA D.O. |
| Entity Type: | Individual |
| Taxonomy Code: | 207Q00000X |
| Specialty: | Family Medicine |
| License Number: | TB009726 |
Most Important Dates
| Enumeration Date: | 07/29/2005 |
| Last Updated: | 09/21/2020 |
Provider Practice Location
3700 52ND ST SE
GRAND RAPIDS
MI
495129637
Practice Location Phone/Fax
| Phone: | 6166563700 |
| Fax: | 6166563701 |
Provider Mailing Location
3700 52ND ST SE
GRAND RAPIDS
MI
495129637
Provider Mailing Phone/Fax
| Phone: | 6166563700 |
| Fax: | 6166563701 |
Suggested EMR
Family Practice EMR