Individual
DR. ALAN IRA REBENSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7272
(616) 361-5828
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7272
(616) 361-5828
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301088832
MI
2085R0202X
Diagnostic Radiology Physician
MD422684
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101117842
—
PA
Enumeration date
01/24/2006
Last updated
04/16/2024
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