MATTHEW LICERALDE ELLOSO

GRAND RAPIDS, MI
NPI1447563150
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: MI  4301096516)
Enumeration Date2010-07-22
Last Update Date2021-06-28
Business Address
Dr. MATTHEW LICERALDE ELLOSO M.D.
100 MICHIGAN ST NE SUITE A721
GRAND RAPIDS, MI 49503-2560
Phone number: 616-391-3139
Mailing Address
Dr. MATTHEW LICERALDE ELLOSO M.D.
100 MICHIGAN ST NE MC 845
GRAND RAPIDS, MI 49503-2560
Phone number:
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