Individual
DR. MICHAEL S JAKUBOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 LAFAYETTE AVE SE, SUITE 301, GRAND RAPIDS, MI 49503-4656
(616) 459-0801
(616) 459-4065
Mailing address
350 LAFAYETTE AVE SE, SUITE 301, GRAND RAPIDS, MI 49503-4656
(616) 459-0801
(616) 459-4065
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MJ043600
MI
225400000X
Rehabilitation Practitioner
MJ043600
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1839854
—
MI
01
—
MJ043600
STATE LICENSE
MI
Enumeration date
06/01/2006
Last updated
12/11/2013
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