Individual
ROY W WADDELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 E PARIS AVE SE, SUITE 215, GRAND RAPIDS, MI 49546-3680
(616) 949-8945
(616) 949-1115
Mailing address
1000 E PARIS AVE SE, SUITE 215, GRAND RAPIDS, MI 49546-3680
(616) 949-8945
(616) 949-1115
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301040667
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1310222
—
MI
Enumeration date
03/29/2006
Last updated
07/08/2007
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