Individual
WAEL BERJAOUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4100 LAKE DR SE, SUITE 200, GRAND RAPIDS, MI 49546-8292
(616) 267-8244
(616) 267-7272
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
(616) 486-6702
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
4301089551
MI
207RP1001X
Pulmonary Disease Physician
4301089551
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M12620022
MEDICARE
MI
Enumeration date
09/14/2006
Last updated
05/20/2024
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