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

Edward Tanudjaja, DO

Individual provider Internal Medicine Physician · NPI 1003499229

Edward Tanudjaja, DO is an Internal Medicine in Muskegon, Michigan. Graduated from Arizona College of Osteopathic Medicine Mid Western University in 2021, 5 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
5
Trained at
Arizona College of Osteopathic Medicine Mid Western University
Licensed in
MI
In the registry since
2021
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone: (231) 672-2000
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 5151015204 (MI)

Record details

NPI number1003499229
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedMay 5, 2021
Last updated in NPPESMay 5, 2021
Certification dateMay 5, 2021
Mailing address18379 Woodland Ridge Dr Apt 6, Spring Lake, MI 49456-8924

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY
Graduated 2021 (5 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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