Provider Demographics
NPI:1891173647
Name:KUNAK, REBECCA LYNN (DO)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:KUNAK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:35 MICHIGAN ST NE # MC056
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2514
Mailing Address - Country:US
Mailing Address - Phone:616-690-1707
Mailing Address - Fax:
Practice Address - Street 1:35 MICHIGAN ST NE # MC056
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2514
Practice Address - Country:US
Practice Address - Phone:616-669-0170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-13
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA008420207ZP0102X
NMA-2325-20207ZP0102X
MI5101026047207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology