Individual
DR. MARTIN JOHN FAASSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3550 FAIRLANES SW, GRANDVILLE, MI 49418
(616) 534-3920
(616) 534-0801
Mailing address
PO BOX 164, GRANDVILLE, MI 49468
(616) 534-3920
(616) 534-0801
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MF000943
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1421894
—
MI
01
—
5415000
BCBS OF MICHIGAN
—
Enumeration date
09/13/2006
Last updated
02/03/2010
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