Provider Demographics
NPI:1265547731
Name:KUE, ELEANORE RANILDE (MD)
Entity type:Individual
Prefix:MRS
First Name:ELEANORE
Middle Name:RANILDE
Last Name:KUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELEANORE
Other - Middle Name:RANILDE
Other - Last Name:TSEMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:973 OTTAWA AVE NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-1431
Mailing Address - Country:US
Mailing Address - Phone:616-391-7752
Mailing Address - Fax:616-391-7733
Practice Address - Street 1:306 S CREYTS RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-8289
Practice Address - Country:US
Practice Address - Phone:517-321-2780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010730642083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine