Individual
MR. CYPRIAN A GARDINE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LAFAYETTE AVE SE, STE 2045, GRAND RAPIDS, MI 49503-4692
(616) 685-3098
(616) 685-3095
Mailing address
1900 44TH ST SE, KENTWOOD, MI 49508-5008
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
4301106353
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200861900
—
IN
Enumeration date
05/03/2007
Last updated
12/15/2021
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