| |
35 Michigan St Ne Ste 1800, Grand Rapids, MI 49503-2568 | |
(616) 391-3933 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Pediatrics - Pediatric Endocrinology |
Location | 35 Michigan St Ne Ste 1800, Grand Rapids, Michigan |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326599671 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
2080P0205X | Pediatrics - Pediatric Endocrinology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
100 Michigan St Ne, Mc 845, Grand Rapids, MI 49503-2560 Ph: () - | 35 Michigan St Ne Ste 1800, Grand Rapids, MI 49503-2568 Ph: (616) 391-3933 |