Most Relevant Information
Provider Data
| NPI Number: | 1003475765 |
| Provider Name: | ALEXANDER MICHAEL SHANNON DO |
| Entity Type: | Individual |
| Taxonomy Code: | 208800000X |
| Specialty: | Urology |
| License Number: | 5151013433 |
Most Important Dates
| Enumeration Date: | 06/06/2019 |
| Last Updated: | 08/06/2024 |
Provider Practice Location
1900 WEALTHY ST SE STE 100
GRAND RAPIDS
MI
495062969
Practice Location Phone/Fax
| Phone: | 6162677333 |
| Fax: |
Provider Mailing Location
100 MICHIGAN ST NE # MC845
GRAND RAPIDS
MI
495032560
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |
Suggested EMR
Urologist EMR