Individual
DR. KENNETH SCOTT HEERINGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9756
(616) 364-4200
(616) 364-7347
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9756
(616) 364-4200
(616) 364-7347
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
1803
WI
207L00000X
Anesthesiology Physician
Primary
5101013374
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972582567
—
WI
05
—
4478999
—
MI
Enumeration date
01/11/2006
Last updated
04/30/2024
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