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

Randall W. Green MD PC

Organization Internal Medicine Physician · NPI 1538489828

Randall W. Green MD PC is an Internal Medicine Physician in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2010.

Licensed in
MI
In the registry since
2010
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

4070 Lake Dr SE Ste 201
Grand Rapids, MI 49546-8294
Phone: (616) 774-8200
Fax: (616) 774-0304
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X (MI)

Record details

NPI number1538489828
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Randall Green — President · (616) 774-8200
NPI enumeratedJune 9, 2010
Last updated in NPPESJune 9, 2010
Mailing address4070 Lake Dr Se Ste 201, Grand Rapids, MI 49546-8294

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