Individual
EDWARD LAWRENCE DEMAAGD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4635 LUCAS DR SW, GRANDVILLE, MI 49418-2293
(616) 633-3086
Mailing address
4635 LUCAS DR SW, GRANDVILLE, MI 49418-2293
(616) 633-3086
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
4704300359
MI
Other
Enumeration date
04/15/2020
Last updated
04/15/2020
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