Individual
DR. VINCENT A DUBRAVEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5055 PLAINFIELD AVE NE, SUITE C, GRAND RAPIDS, MI 49525-1075
(616) 988-8515
Mailing address
5055 PLAINFIELD AVE NE, SUITE C, GRAND RAPIDS, MI 49525-1075
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
4301073903
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301073903
STATE MEDICAL LICENSE
MI
Enumeration date
02/21/2006
Last updated
08/03/2007
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