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Individual

DR. JAMES M POUILLON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3050 IVANREST AVE SW STE E, GRANDVILLE, MI 49418-1400
(616) 406-0102
(616) 406-0105
Mailing address
3050 IVANREST AVE SW STE E, GRANDVILLE, MI 49418-1400
(616) 406-0102
(616) 406-0105

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901002014
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4548420
MI
Enumeration date
10/02/2006
Last updated
12/15/2017
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