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Individual

JAMIE L. CAUGHRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
250 CHERRY ST SE, GRAND RAPIDS, MI 49503-4608
(616) 685-6756
Mailing address
245 STATE ST SE, STE 221, GRAND RAPIDS, MI 49503-4328

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301080258
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1215156336
MI
Enumeration date
04/25/2007
Last updated
10/01/2009
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