Individual
DANIEL M WESOLOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 391-1680
Mailing address
2537 MOMENTUM PL, CHICAGO, IL 60689-5325
(616) 975-1845
(616) 285-0846
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704232669
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00644985
RAILROAD MEDICARE
MI
01
—
P00774326
RAILROAD MEDICARE
MI
Enumeration date
08/30/2006
Last updated
11/02/2011
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