Michael E. Havens, RD, LD, CNSC

Physician Assistant · Fremont, MI

Individual Active NPI

NPI number 1679824361

Practice location

212 S Sullivan Ave
Fremont, MI 49412-1548
Phone
(616) 391-3139
Fax
(616) 391-3044

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NPI record

NPI
1679824361
Entity type
Individual (Type 1)
Enumeration date
September 21, 2012
Last updated
June 3, 2016
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 5601007732 MI

Mailing address

100 Michigan St NE
Mail Code 845
Grand Rapids, MI 49503-2560
Phone
(616) 486-6790
Fax
(616) 486-6702

About Michael Havens

Michael E. Havens, RD, LD, CNSC is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 212 S Sullivan Ave, Fremont, MI 49412-1548. The NPI number 1679824361 was assigned on September 21, 2012 and the record was last updated on June 3, 2016.

Michael Havens lists a license in the registry: #5601007732 (MI) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Michael E. Havens, RD, LD, CNSC?

The NPI number is 1679824361.

What is the phone number of Michael Havens?

The phone number listed for the practice location is (616) 391-3139.

Where is Michael Havens located?

212 S Sullivan Ave, Fremont, MI 49412-1548.

What is the taxonomy code for Michael Havens?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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