Provider Demographics
NPI:1639275746
Name:FINN, MARY GRACE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:GRACE
Last Name:FINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:GRACE FINN
Other - Last Name:DEWEESE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:120 E JOLLY RD
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-6611
Mailing Address - Country:US
Mailing Address - Phone:517-887-1713
Mailing Address - Fax:
Practice Address - Street 1:120 E JOLLY RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-6647
Practice Address - Country:US
Practice Address - Phone:517-887-1713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301044881207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics