Individual
GLENN VANOTTEREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4100 LAKE DR SE, S-200, GRAND RAPIDS, MI 49546-8292
(616) 949-8244
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
4301058500
MI
207RP1001X
Pulmonary Disease Physician
430108500
MI
Other
Enumeration date
06/07/2006
Last updated
05/20/2024
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