Organization
WEST MICHIGAN ENT PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND ROBERT KOMRAY M.D. (PHYSICIAN)
(231) 739-9095
Entity
Organization
Contact information
Practice address
1365 MERCY DR, MUSKEGON, MI 49444-1837
(231) 739-9095
(231) 739-6439
Mailing address
1365 MERCY DR, MUSKEGON, MI 49444-1837
(231) 739-9095
(231) 739-6439
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0406104502
BLUE CROSS BLUE SHIELD OF
MI
05
—
1517752
—
MI
01
—
P55690
BLUE CARE NETWORK
—
Enumeration date
07/13/2007
Last updated
03/07/2023
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