Desibour, Charles L

Desibour, Charles L is an individual health care provider with primary practice located at 100 Michigan St Ne , Grand Rapids MI 49503-2560. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Emergency Medical Services is his primary health care specialty. Desibour, Charles L can be contacted via phone (616) 391-1680.

Contact Information

Primary practice address
100 Michigan St Ne Grand Rapids MI 49503-2560
Phone: (616) 391-1680
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 4301057841 Michigan
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 4301057841 Michigan

Profile Details

NPI number 1891712741
LBN Legal business name Desibour, Charles L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2006
Last updated Apr 27th, 2012 - about 12 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 1891712741 NPPES
Michigan Other 930080726 RAILROAD MEDICARE

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