Individual provider · NPI-1

Miriam Adrianson, MD

Family Medicine · Grand Rapids, MI

NPI number1700441300

StatusActive

Last updated in NPPESOct 5, 2022

Details

NPI: 1700441300
Entity type: Individual (NPI-1)
Name: Miriam Adrianson
Credential: MD
Sex: Female
Sole proprietor: No
Enumeration date: May 8, 2019
Certification date: Oct 5, 2022
Last updated: Oct 5, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207Q00000X	Family Medicine	4301507385	MI	Yes
390200000X	Student in an Organized Health Care Education/Training Program	–	–

Practice location

245 Cherry St Se Ste 100
Grand Rapids, MI 49503-4607

Phone 616-685-3200

Mailing address

20301 Jewell Ave
South Bend, IN 46614-5214

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