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Individual

EANAS S YASSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
275 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2531
(616) 267-8700
(616) 267-8247
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
4301104003
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1396954376
NPI
MI
05
1396954376
MI
Enumeration date
05/22/2007
Last updated
01/27/2025
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