Healthcare Provider Details

I. General information

NPI: 1558310300
Provider Name (Legal Business Name): JULIE A GRONEK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5838 METRO WAY SW
WYOMING MI
49519-9619
US

IV. Provider business mailing address

5838 METRO WAY SW
WYOMING MI
49519-9619
US

V. Phone/Fax

Practice location:
  • Phone: 616-249-5300
  • Fax:
Mailing address:
  • Phone: 616-249-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number4301078628
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number042.0019135
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: