Individual
DR. DONALD VINCENT LA BARGE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339
(616) 361-5828
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339
(616) 361-5828
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
4301080171
MI
2085N0700X
Neuroradiology Physician
6555396-1205
UT
2085R0202X
Diagnostic Radiology Physician
4301080171
MI
2085R0202X
Diagnostic Radiology Physician
6555396-1205
UT
Other
Enumeration date
03/30/2007
Last updated
01/24/2020
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