Male or Other

Dr. Martin P. Greydanus M.D.

Specialist in Grand Rapids, MI(View on Map)

Full Name

Dr. Martin P. Greydanus M.D.

NPI Number

1043215544

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/20/2005

Specialties

(Taxonomies)

Code

174400000X

Primary Taxonomy

Yes

Licenses

State

Michigan

License Number

4301048500

Contact
Information

Purpose

Mailing
Location

Address

310 LAFAYETTE AVE SE
310 LAFAYETTE AVE SE

City

Grand Rapids
Grand Rapids

State

MI
MI

Postal Code

49503-4693
49503-4693

Country

US
US

Telephone Number

(616) 752-6525
(616) 752-6525

Identifiers

Identifier

2701613

Identifier State

MI

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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