Individual
MARISSA MARTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
(616) 455-5960
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
(616) 455-5960
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301504230
MI
2084P0800X
Psychiatry Physician
LP04043
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP04043
STATE OF RHODE ISLAND DEPARTMENT OF HEALTH
RI
Enumeration date
06/15/2017
Last updated
11/22/2022
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