Individual
DR. SUSAN H WAKEFIELD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
877 FOREST HILL AVE SE, GRAND RAPIDS, MI 49546-2325
(616) 949-4465
(616) 949-6191
Mailing address
877 FOREST HILL AVE SE, GRAND RAPIDS, MI 49546-2325
(616) 949-4465
(616) 949-6191
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301044861
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2600380
—
MI
Enumeration date
08/18/2005
Last updated
07/08/2007
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