Individual
ADAM B BLICKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 MIDTOWNE ST NE, SUITE 400, GRAND RAPIDS, MI 49503-5731
(616) 588-1200
(616) 588-1250
Mailing address
555 MIDTOWNE ST NE, SUITE 400, GRAND RAPIDS, MI 49503-5731
(616) 588-1200
(616) 588-1250
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301054233
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3169792
—
MI
Enumeration date
11/08/2005
Last updated
06/15/2011
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