Individual
STUART RAY VERSEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1717 SHAFFER ST, SUITE 108, KALAMAZOO, MI 49048-1647
(269) 343-9113
(269) 343-0510
Mailing address
1717 SHAFFER ST, SUITE 108, KALAMAZOO, MI 49048-1647
(269) 343-9113
(269) 343-0510
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301086883
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0203911911
BCBSM
MI
05
—
4825244
—
MI
Enumeration date
05/11/2006
Last updated
10/02/2009
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