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Individual

ANNICA E WAALKES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
8333 FELCH ST, SUITE 200, ZEELAND, MI 49464-9666
(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
207Q00000X
Family Medicine Physician
Primary
4301087005
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4301087005
MD LICENSE
MI
Enumeration date
05/28/2006
Last updated
02/18/2021
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