Healthcare Provider Details

I. General information

NPI: 1952342230
Provider Name (Legal Business Name): GREGORY A SZYPERSKI D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5570 STATE ST
SAGINAW MI
48603-3583
US

IV. Provider business mailing address

1447 N HARRISON ST
SAGINAW MI
48602-4727
US

V. Phone/Fax

Practice location:
  • Phone: 989-583-0100
  • Fax: 989-583-0108
Mailing address:
  • Phone: 989-583-2833
  • Fax: 989-583-1440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101012313
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: