Individual
THOMAS VISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
890 S WASHINGTON AVE, S-130, HOLLAND, MI 49423-7731
(616) 396-5286
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301059623
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558407189
GROUP NPI
—
01
—
1922090554
CORP NPI
—
Enumeration date
06/09/2006
Last updated
02/18/2021
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