Individual
EUGENE TAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LAFAYETTE AVE SE, GRAND RAPIDS, MI 49503-4692
(616) 685-6922
(616) 685-5101
Mailing address
245 STATE ST SE, GRAND RAPIDS, MI 49503-4328
(616) 685-1808
(616) 685-1850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301076395
MI
208M00000X
Hospitalist Physician
Primary
4301076395
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4518735
—
MI
05
—
4518753
—
MI
05
—
4876898
—
MI
Enumeration date
05/25/2006
Last updated
04/27/2022
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