Individual
DR. JASON THOMAS WANAMAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 ATKINSON DR, LUDINGTON, MI 49431-1906
(231) 843-2591
Mailing address
4100 EMBASSY DR SE STE 4004100, GRAND RAPIDS, MI 49546-2416
(616) 975-1845
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301509881
MI
207P00000X
Emergency Medicine Physician
Primary
4351047995
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2021
Last updated
12/27/2023
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