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1184636953
JOHN STEPHEN EBROM
GRAND RAPIDS, MI
NPI
1184636953
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine
(Licence: MI 4301044412)
Enumeration Date
2006-08-12
Last Update Date
2007-08-20
Business Address
-- JOHN STEPHEN EBROM MD
200 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Phone number: 616-364-6700
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Mailing Address
-- JOHN STEPHEN EBROM MD
PO BOX 77000 DEPT #77339
DETROIT, MI 48277-0339
Phone number: 616-364-6700
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