Individual
MR. KEVIN SISTANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.A.
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503
(616) 364-4200
(616) 364-7347
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
(616) 364-7347
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
28513167
MI
367H00000X
Anesthesiologist Assistant
—
MO
Other
Enumeration date
04/08/2019
Last updated
09/30/2019
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