Dr. Randall William Green, MD - Grand Rapids, MI

Dr. Randall William Green, MD

Specialist in Grand Rapids, Michigan

NPI 1467400333

Randall William Green is a Specialist based in Grand Rapids, MI. Randall William Green practices in Grand Rapids, MI and has the professional credentials of MD. The NPI Number for Randall William Green is 1467400333 and holds a License No. RG030071 (Michigan).

The current practice location address for Randall William Green is 4070 Lake Dr Se, Grand Rapids, MI and can be reached out via phone at 616-774-8200 and via fax at 616-774-0304.

Location: 4070 Lake Dr Se, Grand Rapids, MI, 49546-8294

NPI Number

1467400333

Provider Name

Randall William Green

Credential

Provider Entity Type

Individual

Gender

Male

Address

4070 Lake Dr Se, Grand Rapids, MI, 49546-8294

Phone Number

616-774-8200

Fax Number

616-774-0304

Provider Enumeration Date

05/04/2006

Last Update Date

03/08/2024

Identifier	Type	State	Issuer
110158828	01	MI	RAILROAD MEDICARE
RG030071	01	MI	STATE LICENSE NUMBER
1104110132	01	MI	BLUE CROSS BLUE SHIELD
1073594	05	MI

Address

4070 Lake Dr Se

City

Grand Rapids

State

Michigan

Zip

49546-8294

Phone Number

616-774-8200

Fax Number

616-774-0304

Address

4070 Lake Dr Se

City

Grand Rapids

State

Michigan

Zip

49546-8294

Phone Number

616-774-8200

Fax Number

616-774-0304

Type

Other Service Providers

Classification

Specialist

Speciality

Taxonomy

174400000X

License No.

RG030071 (Michigan)

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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