Individual
DR. BRETT DAVID KUCEJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339
(616) 361-5828
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339
(616) 361-5828
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
35.087687
OH
2085R0202X
Diagnostic Radiology Physician
Primary
4301078351
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105014
COMMERCIAL
MI
01
—
300C376020
BCBS
MI
01
—
300C376030
BCBS
MI
01
—
381879056
COMMERCIAL
MI
05
—
4996493
—
MI
Enumeration date
07/08/2006
Last updated
05/03/2019
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