Individual
IAN DEGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
14755 215TH AVE, BIG RAPIDS, MI 49307-9224
(231) 796-3200
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2545130259
MI
Other
Enumeration date
03/24/2025
Last updated
07/14/2025
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