Individual
DANIEL R FAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
35 MICHIGAN ST NE, SUITE 3003, GRAND RAPIDS, MI 49503-2514
(616) 267-2500
(616) 267-2501
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
4301069422
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4352208
—
MI
Enumeration date
01/19/2006
Last updated
03/08/2021
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