MEDICARE: JOI J GRIER

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
1	172A00000X	Driver	G660430368020	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235783077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOI J GRIER

Provider Business Mailing Address
First Line	:	3345 MEDBURY ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48211-3045
Country	:	US
Telephone Number	:	313-424-9827
Fax Number	:

Provider Business Practice Location Address
First Line	:	3347 MEDBURY ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48211-3045
Country	:	US
Telephone Number	:	313-424-9827
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2019
Last Update Date	:	07/30/2019

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Directions to “ JOI J GRIER ” Practice Location

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