OrganizationActive
Mfb Professional Services Inc
NPI 1003909524 · Sports Medicine (Orthopaedic Surgery) Physician · Grand Rapids, MI
Provider details
- NPI number
- 1003909524
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Randall Deneff, Vp Finance(616) 242-0403
- License
- 4301059802 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1155 E. Paris, Ste 200
Grand Rapids, MI 49546
Phone: (616) 233-3480
Fax: (616) 233-3481
Approximate (ZIP-level) locationGet directions
Mailing address
235 Wealthy Se
Grand Rapids, MI 49503
Registry dates
- Enumerated
- 2006-10-02
- Last updated
- 2013-02-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.