Organization
ALLERGY & ASTHMA CENTERS OF WEST MICHIGAN, P.C.
Active
Other names
Allergy/Asthma Specialists W. MI
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT DUBRAVEC MD (PRESIDENT)
(616) 988-8515
Entity
Organization
Contact information
Practice address
5055 PLAINFIELD AVE NE, SUITE C, GRAND RAPIDS, MI 49525-1075
(616) 988-8515
Mailing address
5055 PLAINFIELD AVE NE, SUITE C, GRAND RAPIDS, MI 49525-1075
(616) 988-8515
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
4301073903
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301073903
STATE MEDICAL LICENSE
MI
05
—
4395260
—
MI
Enumeration date
03/04/2008
Last updated
03/04/2008
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