MR. Michael E Havens, RD, LD, CNSC

NPI #1679824361 in Fremont, Michigan

Provider Information

NPI Number: 1679824361
Entity Type: Individual
Name: MR. Michael E Havens, RD, LD, CNSC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: RD, LD, CNSC
Enumeration Date: Sep 21, 2012
Last Updated: Jun 3, 2016

Practice Location

Address: 212 S SULLIVAN AVE
City: Fremont
State: Michigan
ZIP Code: 49412-1548
Phone: (616) 391-3139

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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