Crissman, Molly P

Crissman, Molly P is an individual health care provider with primary practice located at 15100 Whittaker Way , Grand Haven MI 49417-8696. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Crissman, Molly P can be contacted via phone (616) 935-6320.

Contact Information

Primary practice address
15100 Whittaker Way Grand Haven MI 49417-8696
Phone: (616) 935-6320
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301068764 Michigan

Profile Details

NPI number 1902808165
LBN Legal business name Crissman, Molly P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Feb 24th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902808165 NPPES
Michigan MEDICAID 3352508

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