Individual
MR. NATHAN ZACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 364-4200
(616) 364-7347
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
(616) 364-7347
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
32697863
MI
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
03/31/2021
Last updated
05/25/2021
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