Individual
BRUCE MICHAEL FLETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
588 E LAKEWOOD BLVD, HOLLAND, MI 49424-2023
(616) 494-5830
(616) 494-5901
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301079312
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558407189
GROUP NPI
—
01
—
1922090554
CORP NPI
—
Enumeration date
05/31/2006
Last updated
03/17/2021
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