Basic Information
| Provider Information | |||||||||
| NPI: | 1104827104 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHEEK | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 370 120TH AVE | ||||||||
| Address2: | |||||||||
| City: | HOLLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494242196 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6163965855 | ||||||||
| FaxNumber: | 6163965720 | ||||||||
| Practice Location | |||||||||
| Address1: | 370 120TH AVE | ||||||||
| Address2: | |||||||||
| City: | HOLLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494242196 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6163965855 | ||||||||
| FaxNumber: | 8775920688 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2005 | ||||||||
| LastUpdateDate: | 06/09/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | MC081257 | MI | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 4499783 | 05 | MI | MEDICAID | MC081257 | 01 | MI | BCBS LICENSE | OTHER | P25479F | 01 | MI | BLUE CARE NETWORK | OTHER |