Individual
HENRIKAS ERWIN VAITKEVICIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
100 MICHIGAN NE, GRAND RAPIDS, MI 49503
(616) 391-1680
Mailing address
PO BOX 3536, GRAND RAPIDS, MI 49501-3536
(616) 975-1845
(616) 975-1845
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601002391
MI
Other
Enumeration date
09/21/2006
Last updated
11/09/2009
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