Healthcare Provider Details

I. General information

NPI: 1437958329
Provider Name (Legal Business Name): GREGORY PUNCHES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1546 CALLIS RD
LAPEER MI
48446-7505
US

IV. Provider business mailing address

1546 CALLIS RD
LAPEER MI
48446-7505
US

V. Phone/Fax

Practice location:
  • Phone: 302-762-4279
  • Fax:
Mailing address:
  • Phone: 302-762-4279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: GREGORY PUNCHES
Title or Position: SOLE MBR
Credential: MD
Phone: 302-762-4279