Individual
DR. GENE FONGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
144 MONROE CENTER ST NW, GRAND RAPIDS, MI 49503-2802
(616) 459-0641
(616) 459-0621
Mailing address
144 MONROE CENTER ST NW, GRAND RAPIDS, MI 49503-2802
(616) 459-0641
(616) 459-0621
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
4901002505
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5041964
—
MI
01
—
5474550001
ADMINASTAR
MI
01
—
900D114850
BCBS PIN #
MI
Enumeration date
05/25/2006
Last updated
06/26/2013
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