Individual
DR. BRIAN C FEDESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7272
(616) 363-7290
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7272
(616) 363-7290
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
4301406955
MI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
4301406955
MI
Other
Enumeration date
07/17/2006
Last updated
08/03/2009
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