Individual
JOHN STATHAKIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
275 MICHIGAN ST NE FL 8, GRAND RAPIDS, MI 49503-2531
(616) 391-8810
Mailing address
275 MICHIGAN ST NE FL 8, GRAND RAPIDS, MI 49503-2531
(616) 391-8810
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
—
—
208000000X
Pediatrics Physician
Primary
4351051157
MI
Other
Enumeration date
01/11/2019
Last updated
02/12/2025
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