Individual
GERARD FARRAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3264 N EVERGREEN DRIVE NE, GRAND RAPIDS, MI 49525
(616) 363-7272
(616) 361-5828
Mailing address
3264 N EVERGREEN DRIVE NE, GRAND RAPIDS, MI 49525
(616) 363-7272
(616) 361-5828
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
GF407494
MI
2085R0204X
Vascular & Interventional Radiology Physician
GF407494
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174543102
—
MI
01
—
300E676040
BLUE CROSS
MI
Enumeration date
07/20/2006
Last updated
06/26/2023
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