IndividualActive
Jordan Reilly, MD
NPI 1174053458 · Surgical Critical Care Physician · Grand Rapids, MI
Provider details
- NPI number
- 1174053458
- Entity type
- Individual
- Primary specialty
- Surgical Critical Care PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 4301509594 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
100 Michigan St Ne Ste A601
Grand Rapids, MI 49503-2560
Phone: (616) 267-1712
Fax: (616) 391-8611
Approximate (ZIP-level) locationGet directions
Mailing address
25859 Glenmoor
Novi, MI 48374-2354
Registry dates
- Enumerated
- 2017-06-19
- Last updated
- 2023-07-31
- Certified
- 2023-07-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.