Basic Information
| Provider Information | |||||||||
| NPI: | 1205806858 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIGG | ||||||||
| FirstName: | RYAN | ||||||||
| MiddleName: | E. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 100 MICHIGAN ST NE | ||||||||
| Address2: | MC 845 | ||||||||
| City: | GRAND RAPIDS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 495032560 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | |||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4100 LAKE DR SE | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | GRAND RAPIDS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 495468292 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6162677100 | ||||||||
| FaxNumber: | 6162677102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2006 | ||||||||
| LastUpdateDate: | 03/17/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 03/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 4301076419 | MI | Y | Allopathic & Osteopathic Physicians | Surgery | 208C00000X | 4301076419 | MI | N | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0985694 | 01 | MI | HEALTHPLUS OF MI HMO | OTHER | 1430030 | 01 | MI | IBA HEALTH PLANS | OTHER | 0D17641006 | 01 | MI | MEDICARE PLUS BLUE | OTHER | 7795802 | 01 | MI | AETNA | OTHER | 382031033 | 01 | MI | COMMUNITY CHOICE MICHIGAN | OTHER | 143008 | 01 | MI | PREFERRED CHOICES | OTHER | 5577332 | 01 | MI | CIGNA | OTHER | 020D176410 | 01 | MI | BLUECARE NETWORK GROUP | OTHER | 382031033 | 01 | MI | GREAT WEST LIFE | OTHER | 4864340 | 05 | MI | MEDICAID |