Individual
DONALD E WILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
751 KENMOOR AVENUE SE BRIGHTWAVE PAIN THERAPY, GRAND RAPIDS, MI 49546
(616) 608-5551
(616) 608-5551
Mailing address
751 KENMOOR AVENUE SE BRIGHTWAVE PAIN THERAPY, GRAND RAPIDS, MI 49546
(616) 608-5551
(616) 608-5551
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
25116-021
WI
207P00000X
Emergency Medicine Physician
34 002975
OH
207P00000X
Emergency Medicine Physician
Primary
5101006554
MI
207P00000X
Emergency Medicine Physician
OS-3647
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184641771
—
MI
05
—
3469627
—
MI
05
—
3469645
—
MI
01
—
5651018
BCBS
MI
01
—
DW006554
BLUESHIELD
MI
Enumeration date
07/17/2006
Last updated
02/01/2019
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