Provider Demographics
NPI:1093129173
Name:NATWICK, RAYLENE FRANCES (MD)
Entity Type:Individual
Prefix:
First Name:RAYLENE
Middle Name:FRANCES
Last Name:NATWICK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:221 MICHIGAN ST NE # MC106
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2543
Mailing Address - Country:US
Mailing Address - Phone:616-391-1691
Mailing Address - Fax:616-391-8611
Practice Address - Street 1:221 MICHIGAN ST NE # MC106
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2543
Practice Address - Country:US
Practice Address - Phone:616-391-1691
Practice Address - Fax:616-391-8611
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301105559208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery