Individual
MICHAEL T STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4444 KALAMAZOO AVE SE, KENTWOOD, MI 49508-4600
(616) 391-5600
(616) 391-5685
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301091484
MI
Other
Enumeration date
04/06/2007
Last updated
03/02/2021
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