Fanning, Justin Shayne
Fanning, Justin Shayne is an individual health care provider with primary practice located at 221 Michigan St Ne Ste 300 , Grand Rapids MI 49503-2537. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Fanning, Justin Shayne can be contacted via phone (616) 459-7258.Contact Information
Primary practice address
221 Michigan St Ne Ste 300
Grand Rapids MI 49503-2537
Phone: (616) 459-7258
Fax: (616) 459-5215
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 4301074884 | Michigan |
Profile Details
| NPI number | 1700908522 |
|---|---|
| LBN Legal business name | Fanning, Justin Shayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 4th, 2007 |
| Last updated | Mar 14th, 2022 - 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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