Individual
KOSTADINOS VERGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3443 FARR RD, FRUITPORT, MI 49415-8779
(231) 672-2900
Mailing address
1675 LEAHY ST STE 315A, MUSKEGON, MI 49442-5543
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5151015241
MI
Other
Enumeration date
05/03/2021
Last updated
05/03/2021
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