Individual
LORRIE JEAN OLDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 752-6090
Mailing address
245 STATE ST SE, STE 1A, GRAND RAPIDS, MI 49503-4328
(616) 913-1808
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
5101013310
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
DOC-053
GU
208600000X
Surgery Physician
5101013310
MI
Other
Enumeration date
05/19/2006
Last updated
03/12/2026
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