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

Individual provider Emergency Medicine Physician · NPI 1407177884

David Tetsuji Ishiyama, MD is an Emergency Medicine in Grand Rapids, Michigan. Graduated from Michigan State University College of Human Medicine in 2010, 16 years ago. Practices with Independent Emergency Physicians PC, a 157-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
16
Trained at
Michigan State University College of Human Medicine
Licensed in
MI
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1000 Monroe Ave NW Grmep
Grand Rapids, MI 49503-1455
Phone: (616) 391-8879
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 4301096372 (MI)

Record details

NPI number1407177884
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 19, 2010
Last updated in NPPESMay 31, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolMICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Graduated 2010 (16 years in practice)
Group practice Independent Emergency Physicians Pc — 157 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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