NPI 1184636953

John Stephen Ebrom, MD

Practitioner Clinical Pathology/Laboratory Medicine Physician Grand Rapids, MI

Practice location

Address: 200 Jefferson Ave SE, Grand Rapids, MI 49503
Phone: (616) 364-6700
Fax: (616) 364-4960
Mailing address: PO Box 77000 Dept #77339, Detroit, MI 48277-0339

Registered specialties

Clinical Pathology/Laboratory Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207ZP0105X Licence 4301044412 (MI)

Other Pathology providers in Michigan →

Registry record

NPI: 1184636953
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Aug 2006
Record last updated: 20 Aug 2007

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.