Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 57-013331 | OH |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 4301102440 | MI |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | A119772 | CA |
NPI | 1215107636 |
---|---|
Provider Name | Dr. John W Kemppainen |
First Address | Grand Rapids, MI 49503-2560 |
Second Address | Grand Rapids, MI 49503-2514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2008 |
Last Update Date | 24/02/2021 |