Individual
KONSTANTIN VOLOD ELISEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25 MICHIGAN ST NE, SUITE 6100, GRAND RAPIDS, MI 49503-2515
(616) 267-7900
(616) 267-7901
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
060725
MI
Other
Enumeration date
12/01/2006
Last updated
12/03/2021
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