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Individual

DR. LARRY J ROBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2900 BRADFORD ST NE, GRAND RAPIDS, MI 49525-6427
(616) 885-5000
(616) 913-9025
Mailing address
PO BOX 152057, GRAND RAPIDS, MI 49515-2057
(616) 885-5000
(616) 913-9025

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
4301025828
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4301610
MI
01
770002740
RAILROAD MEDICARE
MI
Enumeration date
11/03/2005
Last updated
11/05/2010
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