Fonger, Gene
Fonger, Gene is an individual health care provider with primary practice located at 144 Monroe Center St Nw , Grand Rapids MI 49503-2802. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Fonger, Gene can be contacted via phone (616) 459-0641.Contact Information
Primary practice address
144 Monroe Center St Nw
Grand Rapids MI 49503-2802
Phone: (616) 459-0641
Fax: (616) 459-0621
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 4901002505 | Michigan |
Profile Details
| NPI number | 1649226499 |
|---|---|
| LBN Legal business name | Fonger, Gene |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2006 |
| Last updated | Jun 26th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649226499 | NPPES |
| Michigan | Other | 5474550001 | ADMINASTAR |
| Michigan | Other | 900D114850 | ADMINASTAR |
| Michigan | MEDICAID | 5041964 | ADMINASTAR |
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