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Individual

PHILIP W TATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8333 FELCH ST, SUITE 200, ZEELAND, MI 49464-2608
(616) 772-4846
(616) 748-2855
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
4301046008
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4877385
MI
Enumeration date
07/13/2006
Last updated
08/06/2012
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