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General NPI Number Information
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NPI Number | 1053470146
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Entity Type | Organization
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Legal Business Name | JERRY M. GREIB PC
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 12/29/2010
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Provider Practice Location Address
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Address Line | 38935 ANN ARBOR RD
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City | LIVONIA
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State | MI
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Zip | 48150-3397
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Country | US
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Telephone | 734-632-0175
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8836
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City | GRAND RAPIDS
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State | MI
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Zip | 49518-8836
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Country | US
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Telephone | 866-898-7139
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Fax | 616-975-9824
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Authorized Official
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Title or Position | OWNER
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Name | JERRY M GREIB
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Credential | DO
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Telephone | 586-493-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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