Individual
DR. ELLIOT CARR PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
330 BARCLAY AVE NE STE 202, GRAND RAPIDS, MI 49503-2525
(616) 443-8007
(616) 458-0061
Mailing address
330 BARCLAY AVE NE STE 201, GRAND RAPIDS, MI 49503-2525
(616) 458-1722
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
1235365081
MI
2086S0120X
Pediatric Surgery Physician
U2104
TX
Other
Enumeration date
06/08/2009
Last updated
03/14/2023
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