Individual
JASON DIPMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AA-C
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503
(616) 364-4200
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 284-3132
(616) 284-3133
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
2011032475
MO
367H00000X
Anesthesiologist Assistant
Primary
1227
MI
Other
Enumeration date
09/27/2011
Last updated
12/13/2018
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