Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ROLLAND DEAN MAMBOURG, MD
Active Sole ProprietorDR. ROLLAND DEAN MAMBOURG, MD is a Family Medicine healthcare provider located in GRAND RAPIDS, Michigan. NPI 1417294620 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · GRAND RAPIDS, MI
Registration Details
- NPI Number
- 1417294620
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 8, 2013 (13.619461821509 yrs)
- Last Updated
- Jan 8, 2013
- License
-
4301039783 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
200 JEFFERSON AVE SEMEDICAL STAFF OFFICEGRAND RAPIDS, MI, 495034502Browse MI providers · Browse ZIP 49503
- Phone
- 6166856612
- Fax
- 6166858921
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in GRAND RAPIDS, MI
| Name | Credential | NPI |
|---|---|---|
| LEE P. BEGROW | DO | 1528062155 |
| DAVID FRANCIS LIEUWEN | M.D. | 1043214414 |
| DR. MATTHEW JAMES BOUTELL | MD | 1043210818 |
| DR. JAMES THOMAS KERBY | MD | 1649270935 |
| TAMMY BORN HUIZENGA | D.O. | 1003816224 |
| WILLIAM H DUKES | MD | 1154322113 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.