Individual
MR. LUKE A CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTIONER
Contact information
Practice address
721 3 MILE RD NW, SUITE 200, GRAND RAPIDS, MI 49544-8229
(616) 647-3770
(616) 647-3776
Mailing address
721 3 MILE RD NW, SUITE 200, GRAND RAPIDS, MI 49544-8229
(616) 647-3770
(616) 647-3776
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F0910484
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F0910484
LICENSE
MI
Enumeration date
01/21/2011
Last updated
01/21/2011
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