Individual
KIMBERLY ANNE MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 685-6902
(616) 685-8995
Mailing address
1900 44TH ST SE, KENTWOOD, MI 49508-5008
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2390-23
WI
363A00000X
Physician Assistant
50-002531
OH
363A00000X
Physician Assistant
Primary
5601007425
MI
363A00000X
Physician Assistant
MA056757
PA
Other
Enumeration date
01/17/2007
Last updated
03/29/2018
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