Individual
DR. AILEEN ELIZABETH M AMPIL ANTONIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
245 CHERRY ST SE, SUITE 204, GRAND RAPIDS, MI 49503-4607
(616) 685-5050
(616) 685-3050
Mailing address
1900 44TH ST SE, KENTWOOD, MI 49508-5008
(616) 391-3130
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
4301097930
MI
2084N0400X
Neurology Physician
Primary
4301097930
MI
Other
Enumeration date
07/01/2011
Last updated
10/19/2016
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