person
Matthew L Waack, MD
Diagnostic Radiology Physician in Grand Rapids, Michigan
NPI 1831151802

Matthew L Waack is a Diagnostic Radiology Physician based in Grand Rapids, MI and is specialized in Diagnostic Radiology. Matthew L Waack practices in Grand Rapids, MI and has the professional credentials of MD. The NPI Number for Matthew L Waack is 1831151802 and holds a License No. 4301073162 (Michigan).

The current practice location address for Matthew L Waack is 3264 N Evergreen Drive Ne, Grand Rapids, MI and can be reached out via phone at 616-363-7272 and via fax at 616-361-5828.

Location: 3264 N Evergreen Drive Ne, Grand Rapids, MI, 49525
person
Provider Profile Details
NPI Number
1831151802
Provider Name
Matthew L Waack
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
3264 N Evergreen Drive Ne, Grand Rapids, MI, 49525
Phone Number
616-363-7272
Fax Number
616-361-5828
Provider Enumeration Date
04/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
G36004069 01 MI MEDICARE PTAN
4336465 05 MI
4336474 05 MI
P113493 01 BXBS MI
institution
Provider Business Practice Location Address Details
Address
3264 N Evergreen Drive Ne
City
State
Zip
49525
Phone Number
616-363-7272
Fax Number
616-361-5828
person
Provider Business Mailing Address Details
Address
3264 N Evergreen Drive Ne
City
State
Zip
49525
Phone Number
616-363-7272
Fax Number
616-361-5828
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
4301073162 (Michigan)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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