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Individual

STEFFEN D GENTHE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 391-1680
Mailing address
2537 MOMENTUM PL, CHICAGO, IL 60689-5325
(616) 975-1845
(616) 285-0846

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301081934
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
4301081934
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00337370
RAILROAD MEDICARE
MI
01
P00446305
RAILROAD MEDICARE
MI
Enumeration date
07/14/2006
Last updated
04/27/2012
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