Individual
LEE O STUART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4294 LAUREL DR, LAKE ODESSA, MI 48849-8430
(616) 374-7660
(616) 374-0270
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301037582
MI
208D00000X
General Practice Physician
4301037582
MI
Other
Enumeration date
08/29/2006
Last updated
09/20/2016
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