Individual
BRIAN M DOLPHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
750 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-6049
(616) 949-2600
(616) 365-2076
Mailing address
750 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-6049
(616) 949-2600
(616) 365-2076
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002301
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00831511
MEDICARE RR
MI
Enumeration date
01/28/2006
Last updated
07/28/2010
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