Individual
DR. JACOB MATTHEW UTASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
80 68TH ST SE, GRAND RAPIDS, MI 49548-6980
(616) 391-8242
(616) 391-8317
Mailing address
100 MICHIGAN ST NE # MC-845, GRAND RAPIDS, MI 49503-2560
(616) 391-8242
(616) 391-8317
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301098739
MI
Other
Enumeration date
06/12/2011
Last updated
01/07/2016
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