Organization
KENTWOOD FAMILY PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE M BAKER D.O. (PRESIDENT)
(616) 281-9066
Entity
Organization
Contact information
Practice address
5070 CASCADE RD SE, SUITE 250, GRAND RAPIDS, MI 49546-8422
(616) 281-9066
(616) 281-0539
Mailing address
5070 CASCADE RD SE, SUITE 250, GRAND RAPIDS, MI 49546-8422
(616) 281-9066
(616) 281-0539
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/16/2006
Last updated
11/20/2007
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