Alexander Corcoran PA-C LLC
Family Medicine in Grand Rapids, MI. Organization (NPI-2).
NPI number1932748050
StatusActive
Last updated in NPPESJan 6, 2020
Details
- NPI
- 1932748050
- Entity type
- Organization (NPI-2)
- Legal business name
- Alexander Corcoran PA-C LLC
- Organization subpart
- No
- Enumeration date
- Jan 6, 2020
- Certification date
- Jan 6, 2020
- Last updated
- Jan 6, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
2340 College Ave SeGrand Rapids, MI 49507-3108
Phone 517-281-2300
Mailing address
2340 College Ave SeGrand Rapids, MI 49507-3108
Authorized official
Alexander J Corcoran
Owner
5172812300
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