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Individual

DR. AMOL SHANTARAM EKHANDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6105 WILSON AVE SW, GRANDVILLE, MI 49418-9714
(616) 486-5100
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301095077
MI
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
4301095077
MI

Other

Enumeration date
03/30/2009
Last updated
02/12/2024
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