Individual
RUSSEL D JELSEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
221 MICHIGAN ST NE, SUITE 600, GRAND RAPIDS, MI 49503-2543
(616) 774-7035
(616) 774-4057
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
RJ407131
MI
207VM0101X
Maternal & Fetal Medicine Physician
Primary
4301407131
MI
Other
Enumeration date
10/25/2005
Last updated
09/01/2015
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