Registry details
Type
Individual
Primary specialty
Internal Medicine, Medical Oncology
Enumerated
Jun 11, 2006
License(s)
4301072694 (MI), 4301072694 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 100 MICHIGAN ST NE # MC845 | Grand Rapids, MI 49503-2560 | |
| LOCATION | 145 MICHIGAN ST NE STE 2200 | Grand Rapids, MI 49503-2562 | 616-486-5933 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.