Individual
MICHAEL STEPHEN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1485 S. M-139, BENTON HARBOR, MI 49022
(269) 925-0585
(269) 925-0070
Mailing address
1485 S. M-139, BENTON HARBOR, MI 49022
(269) 925-0585
(269) 925-0070
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301077450
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4303750
—
MI
Enumeration date
11/02/2006
Last updated
07/08/2007
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