Jeffrey Dufresne
Family Medicine in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1982126355
StatusActive
Last updated in NPPESJan 23, 2019
Details
- NPI
- 1982126355
- Entity type
- Individual (NPI-1)
- Name
- Jeffrey Dufresne
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 7, 2017
- Last updated
- Jan 23, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 4351032393 | MI | Yes |
| 207Q00000X | Family Medicine | 4301113397 | MI |
Practice location
300 Lafayette Ave. SeGrand Rapids, MI 49503
Phone 616-685-6922
Mailing address
300 Lafayette Ave SeGrand Rapids, MI 49503-4692
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