Intengan, Marilyn Estrada

Intengan, Marilyn Estrada is an individual health care provider with primary practice located at 200 Jefferson Ave Se , Grand Rapids MI 49503. She recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine, which is considered as her primary health care specialty. Intengan, Marilyn Estrada can be contacted via phone (616) 364-6700.

Contact Information

Primary practice address
200 Jefferson Ave Se Grand Rapids MI 49503
Phone: (616) 364-6700
Fax: (616) 364-4960
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine 207ZP0105X 4301084873 Michigan

Profile Details

NPI number 1770595563
LBN Legal business name Intengan, Marilyn Estrada
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
Last updated Aug 20th, 2007 - about 17 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 1770595563 NPPES
Michigan MEDICAID 46540263100
Michigan Other P00192611

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