Individual
GIANINA DELEON CORPUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2111 12 MILE RD NW, SPARTA, MI 49345-9754
(616) 391-8470
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301105198
MI
Other
Enumeration date
06/16/2014
Last updated
03/12/2018
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