Individual
KRISHNA MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2900 BRADFORD ST NE, GRAND RAPIDS, MI 49525-6427
(616) 885-5000
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301511599
MI
Other
Enumeration date
04/21/2018
Last updated
09/03/2024
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