Individual
MARK JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
245 CHERRY ST SE, STE 100, GRAND RAPIDS, MI 49503-4607
(616) 685-3200
(616) 458-3526
Mailing address
245 STATE ST SE, GRAND RAPIDS, MI 49503-4328
(616) 685-8050
(616) 685-1850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301056614
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2994945
—
MI
05
—
3506918
—
MI
05
—
4609034
—
MI
05
—
4609043
—
MI
05
—
4609052
—
MI
05
—
4878435
—
MI
Enumeration date
05/23/2006
Last updated
08/17/2012
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