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Individual

MARY ELIZABETH CHARLESTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
275 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2531
(616) 391-2802
(616) 391-2840
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008287
MI

Other

Enumeration date
09/12/2014
Last updated
12/19/2024
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