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Individual

MARTIN J BURY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
710 KENMOOR AVE SE, SUITE 100, GRAND RAPIDS, MI 49546-2379
(616) 954-9800
(616) 954-2116
Mailing address
710 KENMOOR AVE SE, SUITE 100, GRAND RAPIDS, MI 49546-2379
(616) 954-9800
(616) 954-2116

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301046999
MI
207RH0003X
Hematology & Oncology Physician
4301046999
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110215649
RR MEDICARE
MI
Enumeration date
07/20/2005
Last updated
02/24/2014
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