Healthcare Provider Details

I. General information

NPI: 1932190345
Provider Name (Legal Business Name): GREGORY GERHARD PELLIZZON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 S WASHINGTON AVE
SAGINAW MI
48601-2556
US

IV. Provider business mailing address

4000 WELLNESS DR
MIDLAND MI
48670-2000
US

V. Phone/Fax

Practice location:
  • Phone: 989-754-3000
  • Fax: 989-754-3002
Mailing address:
  • Phone: 844-832-1956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number4301070190
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number4301070190
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: