Healthcare Provider Details

I. General information

NPI: 1194231951
Provider Name (Legal Business Name): GREG JAMES DOW MSOM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GREGORY DOW MSOM

II. Dates (important events)

Enumeration Date: 12/15/2017
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E SAGINAW ST
EAST LANSING MI
48823-2740
US

IV. Provider business mailing address

250 E SAGINAW ST
EAST LANSING MI
48823-2740
US

V. Phone/Fax

Practice location:
  • Phone: 517-337-3080
  • Fax: 517-337-3082
Mailing address:
  • Phone: 517-337-3080
  • Fax: 517-337-3082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number5402000314
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: