Individual
DR. MADELON K. KRISSOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
233 E. FULTON, SUITE #102, GRAND RAPIDS, MI 49503
(616) 744-2588
(616) 744-6839
Mailing address
515 LAKESIDE DRIVE SE, SUITE 103, EAST GRAND RAPIDS, MI 49506
(616) 774-2588
(616) 774-6839
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
4301406025
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4116499
—
MI
Enumeration date
05/01/2007
Last updated
08/15/2014
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