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NPI 1558306928

NPI 1558306928 : HONORIO VALDES MURUA MD : GRAND RAPIDS, MI

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General NPI Number Information
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    NPI Number           |    1558306928
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    Entity Type          |    Individual 
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    Provider Name        |    HONORIO VALDES MURUA MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/18/2006
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    Last Update Date     |    04/25/2023
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Provider Practice Location Address
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    Address Line         |    3333 EVERGREEN DR NE 
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    City                 |    GRAND RAPIDS
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    State                |    MI
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    Zip                  |    49525-9493
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    Country              |    US
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    Telephone            |    616-364-4200
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    Fax                  |    616-364-7347
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Provider Business Mailing Address
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    Address Line         |    3333 EVERGREEN DR NE 
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    City                 |    GRAND RAPIDS
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    State                |    MI
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    Zip                  |    49525-9493
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    Country              |    US
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    Telephone            |    616-364-4200
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    Fax                  |    616-364-7347
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    M-2377
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    License Number State |    GU
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Taxonomy #2
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    0420011014
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    License Number State |    VT
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Taxonomy #3
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    4301093674
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    License Number State |    MI
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