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Individual

ROSS E TISRON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
200 N PARK ST, WEST MICHIGAN CANCER CENTER, KALAMAZOO, MI 49007-3731
(269) 382-2500
(269) 373-7478
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-7806
(269) 341-8743

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704162218
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4868770
MI
Enumeration date
05/20/2006
Last updated
03/07/2023
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