Individual
ROBERT L DEMAAGD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 MIDTOWNE ST NE, SUITE 105, GRAND RAPIDS, MI 49503-5729
(616) 459-7101
(616) 464-6170
Mailing address
1111 LEFFINGWELL AVE NE, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
(616) 464-6170
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301052575
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4761568
—
MI
01
—
P00Z40360
RR MEDICARE
—
Enumeration date
10/10/2005
Last updated
11/03/2016
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