Individual
OR GIVOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 MICHIGAN ST NE STE 4200, GRAND RAPIDS, MI 49503-2559
(616) 267-9150
Mailing address
25 MICHIGAN ST NE STE 4200, GRAND RAPIDS, MI 49503-2559
(616) 267-9150
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
4351054936
MI
Other
Enumeration date
08/02/2025
Last updated
08/08/2025
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