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:
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Health care specialties

SpecialtyCodeLicense #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 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 1649226499 NPPES
Michigan Other 5474550001 ADMINASTAR
Michigan Other 900D114850 ADMINASTAR
Michigan MEDICAID 5041964 ADMINASTAR

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