Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Grand Rapids Addiction Medicine Specialists PC

Organization Internal Medicine Physician · NPI 1780642355

Grand Rapids Addiction Medicine Specialists PC is an Internal Medicine Physician in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4100 Lake Dr SE Ste 305
Grand Rapids, MI 49546-8292
Phone: (616) 954-0600
Fax: (616) 954-1675
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 4301047295 (MI)

Record details

NPI number1780642355
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Khan Nedd — President · (616) 954-0600
NPI enumeratedMay 3, 2006
Last updated in NPPESJuly 31, 2007
Mailing addressPo Box 1682, Grand Rapids, MI 49501-1682

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