Healthcare Provider Details

I. General information

NPI: 1275982910
Provider Name (Legal Business Name): RAYMOND YI-SHENG YEOW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 EAGLE RUN DR NE STE 100
GRAND RAPIDS MI
49525-7051
US

IV. Provider business mailing address

3210 EAGLE RUN DR NE STE 100
GRAND RAPIDS MI
49525-7051
US

V. Phone/Fax

Practice location:
  • Phone: 616-456-9553
  • Fax: 616-454-5371
Mailing address:
  • Phone: 616-456-9553
  • Fax: 616-454-5371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number4301117423
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4301109352
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: