Individual
DR. REBEKAH WAKEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
330 BARCLAY AVE NE, GRAND RAPIDS, MI 49503-2556
(616) 391-8810
Mailing address
100 MICHIGAN NEST MC013, GRAND RAPIDS, MI 49503-2560
(616) 267-0075
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301107555
MI
Other
Enumeration date
06/15/2015
Last updated
08/05/2015
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