Healthcare Provider Details

I. General information

NPI: 1962626671
Provider Name (Legal Business Name): GREGORY JAMES ARTZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 10/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 44TH ST SW
WYOMING MI
49509-4313
US

IV. Provider business mailing address

1555 44TH ST SW
WYOMING MI
49509-4313
US

V. Phone/Fax

Practice location:
  • Phone: 616-249-8000
  • Fax: 215-923-4532
Mailing address:
  • Phone: 616-249-8000
  • Fax: 215-923-4532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD422413
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number4301087787
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number4301087787
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: