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NPI Code Detail

MEDICARE: GENESYS PRACTICE PARTNERS INC

MEDICARE: GENESYS PRACTICE PARTNERS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician
22080N0001XNeonatal-Perinatal Medicine Physician
3207RC0000XCardiovascular Disease Physician
42086S0129XVascular Surgery Physician
5208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
6207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1700B510480OTHERMIBCBS GPP GROUP NUMBER

General Provider Information

NPI Number : 1194774752
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENESYS PRACTICE PARTNERS INC
Provider Business Mailing Address
First Line : 1460 N CENTER RD
Second Line :
City : BURTON
State : MI
Zip : 48509-1429
Country : US
Telephone Number : 810-606-5893
Fax Number : 810-606-9560
Provider Business Practice Location Address
First Line : 1 GENESYS PKWY
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-8065
Country : US
Telephone Number : 810-606-5893
Fax Number : 810-606-9560
Authorized Official
Title or Position : DIRECTOR OF PHYSICIAN SERVICES
Name : DAVID LOPEZ
Credential :
Telephone Number : 810-606-5893
Provider Enumeration Date : 05/09/2006
Last Update Date : 04/10/2026

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Directions to “GENESYS PRACTICE PARTNERS INC ” Practice Location

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