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Individual

LAURA DEANN CHAMPION

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3195 KNIGHT WAY SE, GRAND RAPIDS, MI 49546-4406
(616) 526-6187
(616) 469-1398
Mailing address
3195 KNIGHT WAY SE, GRAND RAPIDS, MI 49546-4409
(616) 526-6678
(616) 526-6548

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301068521
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1609147339
CALVIN COLLEGE HEALTH SERVICES GROUP NPI
MI
05
4161028
MI
05
4166848
MI
05
4166857
MI
05
4202588
MI
05
4876913
MI
Enumeration date
05/18/2006
Last updated
07/27/2023
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