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Brandon Ellsworth, MD — NPI 1689848459, Grand Rapids, MI | NPI Central

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NPI 1689848459

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Brandon Ellsworth, MD

NPI 1689848459 · Anatomic Pathology & Clinical Pathology Physician · Grand Rapids, MI

Provider details

NPI number: 1689848459
Entity type: Individual
Primary specialty: Anatomic Pathology & Clinical Pathology PhysicianAllopathic & Osteopathic Physicians
Credential: MD
Sex: Male
Sole proprietor: No
License: 4301102483 (MI)

Specialties & taxonomies

Anatomic Pathology & Clinical Pathology PhysicianPrimary207ZP0102XLicense 4301102483 (MI)
Allopathic & Osteopathic Physicians

Practice location

200 Jefferson Ave Se

Grand Rapids, MI 49503-4502

Phone: (616) 364-6700

Approximate (ZIP-level) locationGet directions

More MI providers

Mailing address

Po Box 1629

Lima, OH 45802-1629

Additional practice locations (1)

5900 Byron Center Ave Sw
Wyoming, MI 49519-9606
Phone: (616) 252-7166

Registry dates

Enumerated: 2008-04-14
Last updated: 2021-07-14
Certified: 2021-07-14

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.