Individual
DONALD EZRA RUTHERFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1159 S HARBOR DR, SUITE C4, GRAND HAVEN, MI 49417-1796
(616) 844-4068
(616) 844-4068
Mailing address
PO BOX 3140, GRAND RAPIDS, MI 49501-3140
(616) 844-4068
(616) 844-4068
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101009705
MI
207QG0300X
Geriatric Medicine (Family Medicine) Physician
5101009705
MI
Other
Enumeration date
02/15/2006
Last updated
03/14/2008
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