Organization
CHARLES J ZICKUS DO PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES J ZICKUS DO (PLC)
(231) 728-5858
Entity
Organization
Contact information
Practice address
1700 CLINTON ST, MUSKEGON, MI 49442-5502
(231) 728-5858
Mailing address
4045 ANTIGO CT SW, GRANDVILLE, MI 49418-3145
(616) 532-2640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101012689
MI
Other
Enumeration date
07/29/2013
Last updated
07/29/2013
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