Organization
MFB PROFESSIONAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL L. DENEFF (VP FINANCE)
(616) 242-0403
Entity
Organization
Contact information
Practice address
1155 E. PARIS, STE 200, GRAND RAPIDS, MI 49546
(616) 233-3480
(616) 233-3481
Mailing address
235 WEALTHY SE, GRAND RAPIDS, MI 49503
(616) 242-0300
(616) 235-3997
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301042627
MI
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
4301059802
MI
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
10/02/2006
Last updated
02/04/2013
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