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Individual

DANIEL MARK SCHELLENBERG

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301054316
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
260D17625
BC/BS
MI
05
3079149
MI
Enumeration date
06/07/2006
Last updated
07/09/2007
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