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Individual

ASHOK SRIRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
275 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2531
(616) 267-7104
(616) 267-7594
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 267-7100
(616) 267-7594

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301102511
MI
2084N0400X
Neurology Physician
ME113347
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007839300
FL
Enumeration date
09/14/2007
Last updated
12/11/2024
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