Provider Demographics
NPI:1659013688
Name:TSALOFF, GRACE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:ELIZABETH
Last Name:TSALOFF
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:25 MICHIGAN ST NE STE 2100
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2526
Mailing Address - Country:US
Mailing Address - Phone:616-391-3777
Mailing Address - Fax:616-391-3755
Practice Address - Street 1:25 MICHIGAN ST NE STE 2100
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2526
Practice Address - Country:US
Practice Address - Phone:616-391-3777
Practice Address - Fax:616-391-3755
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4351049758208000000X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program