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Contact Information

RUSSEL D JELSEMA, MD
221 MICHIGAN ST NE
SUITE 600
GRAND RAPIDS, MI49503-2543
 Phone: 616-774-7035
 Fax: 616-774-4057
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Maternal & Fetal Medicine

207VM0101X 16 Physician/Obstetrics & Gynecology
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for RUSSEL D JELSEMA · (Male)

NPI # 1588654263
Status Active
Credentials MD
Entity Individual
Enumeration date 10/25/2005
Last updated 09/01/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301407131
  • MI License # RJ407131
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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