Basic Information
| Provider Information | |||||||||
| NPI: | 1851341499 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ESTES | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | KEVIN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 479 LAFAYETTE ST | ||||||||
| Address2: | |||||||||
| City: | IONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488461834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6165231400 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 479 LAFAYETTE ST | ||||||||
| Address2: | |||||||||
| City: | IONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488461834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6165231400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2006 | ||||||||
| LastUpdateDate: | 03/18/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD429495 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 5315038044 | MI | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1960691 | 01 | PA | HIGHMARK | OTHER |