Individual
DR. STEPHANE GRIJSEELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 W MAGNETIC ST, MARQUETTE, MI 49855-2711
(906) 225-3540
Mailing address
420 W MAGNETIC ST, MARQUETTE, MI 49855-2711
(906) 225-3540
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301069036
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34089100
—
WI
01
—
4813682
MOLINA HEALTHCARE
MI
05
—
4813682
—
MI
01
—
P00273195
RAILROAD MEDICARE
MI
Enumeration date
09/29/2006
Last updated
07/08/2007
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