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Individual

RAFAEL COMBALECER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1055 MEDICAL PARK DR SE, GRAND RAPIDS, MI 49546-3671
(616) 532-8000
Mailing address
PO BOX 1969, GRAND RAPIDS, MI 49501-1969
(616) 532-8000

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301065889
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4394119
MI
Enumeration date
09/12/2005
Last updated
07/08/2007
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