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General NPI Number Information
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NPI Number | 1790433803
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Entity Type | Organization
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Legal Business Name | GENESYS PRACTICE PARTNERS INC
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 1 GENESYS PKWY STE 3452
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City | GRAND BLANC
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State | MI
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Zip | 48439-8065
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Country | US
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Telephone | 810-606-7550
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Fax |
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Provider Business Mailing Address
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Address Line | 1460 N CENTER RD
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City | BURTON
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State | MI
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Zip | 48509-1429
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Country | US
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Telephone | 810-853-1926
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. DAVID LOPEZ
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Credential |
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Telephone | 810-606-5893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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