Individual
DR. CHRISTOPHER JAMES THERASSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339
(616) 361-5828
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339
(616) 361-5828
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125056692
IL
2085R0202X
Diagnostic Radiology Physician
036.130613
IL
2085R0202X
Diagnostic Radiology Physician
Primary
4301108569
MI
Other
Enumeration date
09/07/2009
Last updated
06/07/2019
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