Individual
BYRON ROLF HISSOM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 E SHERMAN BLVD, MUSKEGON, MI 49444-1849
(231) 672-3883
Mailing address
1560 E SHERMAN BLVD STE 240, MUSKEGON, MI 49444-1854
(231) 672-3883
(231) 672-3973
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301061003
MI
208M00000X
Hospitalist Physician
Primary
4301061003
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4287324
—
MI
Enumeration date
03/14/2006
Last updated
04/23/2022
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