Individual
KEVIN S GOSTENIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 685-6200
Mailing address
PO BOX 5329, SAGINAW, MI 48603-0329
(616) 364-6700
(989) 401-4245
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301086242
MI
Other
Enumeration date
07/26/2007
Last updated
09/10/2019
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