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Individual

DR. KARI ROSE FORMSMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
200 JEFFERSON AVE SE, 9TH FLOOR, GRAND RAPIDS, MI 49503-4502
(616) 685-6501
Mailing address
1900 44TH ST SE, KENTWOOD, MI 49508-5008

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301059866
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4764659
MI
Enumeration date
03/21/2006
Last updated
01/09/2015
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