Srutwa, Thaddeus P.

Srutwa, Thaddeus P. is an sole proprietor health care provider with primary practice located at 16986 Robbins Rd Ste 180 , Grand Haven MI 49417-2795. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Srutwa, Thaddeus P. can be contacted via phone (616) 213-0253.

Contact Information

Primary practice address
16986 Robbins Rd Ste 180 Grand Haven MI 49417-2795
Phone: (616) 213-0253
Fax: (616) 296-2423
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM 204D00000X 4301045363 Michigan
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 4301045353 Michigan
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 4301045353 Michigan

Profile Details

NPI number 1366489635
LBN Legal business name Srutwa, Thaddeus P.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 2nd, 2006
Last updated Aug 5th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366489635 NPPES
Michigan Other 0700125 BLUE CROSS BLUE SHEILD

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