Whalio Doctors

NPI 1003909524

Mfb Professional Services INC

Organisation Sports Medicine (Orthopaedic Surgery) Physician Grand Rapids, MI

Practice location

Address
1155 E. Paris, STE 200, Grand Rapids, MI 49546
Phone
(616) 233-3480
Fax
(616) 233-3481
Mailing address
235 Wealthy SE, Grand Rapids, MI 49503

Authorised official

Name
Randall L. Deneff
Title
Vp Finance
Phone
(616) 242-0403

Registered specialties (4)

Sports Medicine (Orthopaedic Surgery) Physician Primary
Allopathic & Osteopathic Physicians Taxonomy 207XX0005X
Family Medicine Physician
Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 4301042627 (MI)
Sports Medicine (Orthopaedic Surgery) Physician
Allopathic & Osteopathic Physicians Taxonomy 207XX0005X Licence 4301059802 (MI)
Physician Assistant
Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

Registry record

NPI
1003909524
Entity type
Organization
NPI issued
2 Oct 2006
Record last updated
4 Feb 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.