Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Rolland Dean Mambourg, MD

Individual provider Family Medicine Physician · NPI 1417294620

Dr. Rolland Dean Mambourg, MD is a Family Medicine Physician in Grand Rapids, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2013
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

200 Jefferson Ave SE Medical Staff Ofc
Grand Rapids, MI 49503-4502
Phone: (616) 685-6612
Fax: (616) 685-8921
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 4301039783 (MI)

Record details

NPI number1417294620
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJanuary 8, 2013
Last updated in NPPESJanuary 8, 2013

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