Individual
DR. MARCUS SALIM MUALLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
750 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-6049
(616) 949-2600
(616) 954-0213
Mailing address
750 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-6049
(616) 949-2600
(616) 954-0213
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301090063
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5189883
—
MI
01
—
P00458706
MEDICARE RR
MI
Enumeration date
06/01/2007
Last updated
06/09/2008
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