Individual
DAVID TETSUJI ISHIYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 MONROE AVE NW, GRMEP, GRAND RAPIDS, MI 49503-1455
(616) 391-8879
Mailing address
44650 DANBURY RD, CANTON, MI 48188-1050
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301096372
MI
Other
Enumeration date
06/19/2010
Last updated
05/31/2013
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