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Individual

DANIEL W TOME

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2332 ALPINE AVE NW, GRAND RAPIDS, MI 49544-1955
(616) 391-6220
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101011069
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1598712390
GROUP NPI
MI
05
4780957
MI
05
4780966
MI
05
4780975
MI
05
4780984
MI
01
5410116
BCBS PIN #
MI
Enumeration date
05/17/2006
Last updated
07/21/2014
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