JUSTIN SHAYNE FANNING

GRAND RAPIDS, MI
NPI1700908522
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)
(Licence: MI  4301074884)
Enumeration Date2007-04-04
Last Update Date2022-03-14
Business Address
JUSTIN SHAYNE FANNING MD
221 MICHIGAN ST NE STE 300
GRAND RAPIDS, MI 49503-2537
Phone number: 616-459-7258
Mailing Address
JUSTIN SHAYNE FANNING MD
100 MICHIGAN ST NE MC 845
GRAND RAPIDS, MI 49503-2560
Phone number:
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