Individual
DR. JULIE R SHANAVER-BRINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 JEFFERSON SE, GRAND RAPIDS, MI 49503
(616) 752-6781
Mailing address
PO BOX Q, GRAND RAPIDS, MI 49501-4917
(800) 968-6866
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301084221
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5212838
—
MI
01
—
JS084221
BLUE CROSS BLUE SHIELD
MI
01
—
P00429080
RAILROAD MEDICARE
—
Enumeration date
05/01/2007
Last updated
03/17/2026
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