Organization
GRMEP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARIK AL-KALLA M.D. (RESIDENT)
(281) 650-7144
Entity
Organization
Contact information
Practice address
221 MICHIGAN NE STE 200A, GRAND RAPIDS, MI 49503
(616) 391-1691
Mailing address
221 MICHIGAN NE STE 200A, GRAND RAPIDS, MI 49503
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
4301101423
MI
Other
Enumeration date
06/29/2012
Last updated
06/29/2012
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