Organization
GRAND RAPIDS ADDICTION MEDICINE SPECIALISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHAN JAVAN NEDD M.D. (PRESIDENT)
(616) 954-0600
Entity
Organization
Contact information
Practice address
4100 LAKE DR SE, SUITE 305, GRAND RAPIDS, MI 49546-8292
(616) 954-0600
(616) 954-1675
Mailing address
PO BOX 1682, GRAND RAPIDS, MI 49501-1682
(616) 954-0600
(616) 954-1675
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301047295
MI
Other
Enumeration date
05/03/2006
Last updated
07/31/2007
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